RT Journal Article
T1 Relevance of Reference Centers in Sarcoma Care and Quality Item Evaluation: Results from the Prospective Registry of the Spanish Group for Research in Sarcoma (GEIS).
A1 Martin-Broto, Javier
A1 Hindi, Nadia
A1 Cruz, Josefina
A1 Martinez-Trufero, Javier
A1 Valverde, Claudia
A1 De Sande, Luis M
A1 Sala, Angeles
A1 Bellido, Lorena
A1 De Juan, Ana
A1 Rubió-Casadevall, Jordi
A1 Diaz-Beveridge, Roberto
A1 Cubedo, Ricardo
A1 Tendero, Oscar
A1 Salinas, Diego
A1 Gracia, Isidro
A1 Ramos, Rafael
A1 Baguè, Silvia
A1 Gutierrez, Antonio
A1 Duran-Moreno, José
A1 Lopez-Pousa, Antonio
K1 Diagnostic process
K1 Multidisciplinary management
K1 Outcome
K1 Reference centers
K1 Sarcoma
AB Reference centers (RCs) are a key point for improving the survival of patients with soft-tissue sarcomas (STS). The aim of this study was to evaluate selected items in the management of patients with STS, comparing results between RC and local hospitals (LHs). Diagnostic and therapeutic data from patients diagnosed between January 2004 and December 2011 were collected. Correlation with outcome was performed. A total of 622 sarcomas were analyzed, with a median follow-up of 40 months. Imaging of primary tumor preoperatively (yes vs. no) correlated with a higher probability of free surgical margins (77.4% versus 53.7%; p = .006). The provenance of the biopsy (RC vs. LH) significantly affected relapse-free survival (RFS; 3-year RFS 66% vs. 46%, respectively; p = .019). Likewise, 3-year RFS was significantly worse in cases with infiltrated (55.6%) or unknown (43.4%) microscopic surgical margins compared with free margins (63.6%; p  Our series indicate that selected quality-of-care items were accomplished better by RCs over LHs, all with significant prognostic value in patients with STS. Early referral to an RC should be mandatory if the aim is to improve the survival of patients with STS. This prospective study in patients diagnosed with soft-tissue sarcoma shows the prognostic impact of reference centers in the management of these patients. The magnitude of this impact encompasses all steps of the process, from the initial management (performing diagnostic biopsy) to the advanced disease setting. This is the first prospective evidence showing improvement in outcomes of patients with metastatic disease when they are managed in centers with expertise. This study provides extra data supporting referral of patients with sarcoma to reference centers.
YR 2018
FD 2018-11-08
LK http://hdl.handle.net/10668/13162
UL http://hdl.handle.net/10668/13162
LA en
DS RISalud
RD Apr 19, 2025