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. 2019 Jul 1;30(7):1143-1153.
doi: 10.1093/annonc/mdz124.

Surgery in reference centers improves survival of sarcoma patients: a nationwide study

J-Y Blay  1 , C Honoré  2 , E Stoeckle  3 , P Meeus  4 , M Jafari  5 , F Gouin  6 , P Anract  7 , G Ferron  8 , A Rochwerger  9 , M Ropars  10 , S Carrere  11 , F Marchal  12 , F Sirveaux  12 , A Di Marco  13 , L R Le Nail  14 , J Guiramand  15 , G Vaz  4 , J-C Machiavello  16 , O Marco  17 , S Causeret  18 , P Gimbergues  19 , F Fiorenza  20 , L Chaigneau  21 , F Guillemin  22 , J-M Guilloit  23 , F Dujardin  24 , J-P Spano  25 , J-C Ruzic  26 , A Michot  2 , P Soibinet  22 , E Bompas  27 , C Chevreau  8 , F Duffaud  9 , M Rios  10 , C Perrin  10 , N Firmin  11 , F Bertucci  15 , C Le Pechoux  2 , F Le Loarer  2 , O Collard  4 , M Karanian-Philippe  4 , M Brahmi  4 , A Dufresne  4 , A Dupré  4 , F Ducimetière  4 , A Giraud  7 , D Pérol  4 , M Toulmonde  3 , I Ray-Coquard  4 , A Italiano  3 , A Le Cesne  2 , N Penel  5 , S Bonvalot  28 ; NETSARC/REPPS/RESOS and French Sarcoma Group–Groupe d’Etude des Tumeurs Osseuses (GSF-GETO) Networks
Affiliations

Surgery in reference centers improves survival of sarcoma patients: a nationwide study

J-Y Blay et al. Ann Oncol. .

Erratum in

  • Surgery in reference centers improves survival of sarcoma patients: a nationwide study.
    Blay JY, Honoré C, Stoeckle E, Meeus P, Jafari M, Gouin F, Anract P, Ferron G, Rochwerger A, Ropars M, Carrere S, Marchal F, Sirveaux F, Di Marco A, Le Nail LR, Guiramand J, Vaz G, Machiavello JC, Marco O, Causeret S, Gimbergues P, Fiorenza F, Chaigneau L, Guillemin F, Guilloit JM, Dujardin F, Spano JP, Ruzic JC, Michot A, Soibinet P, Bompas E, Chevreau C, Duffaud F, Rios M, Perrin C, Firmin N, Bertucci F, Le Pechoux C, Le Loarer F, Collard O, Karanian-Philippe M, Brahmi M, Dufresne A, Dupré A, Ducimetière F, Giraud A, Pérol D, Toulmonde M, Ray-Coquard I, Italiano A, Le Cesne A, Penel N, Bonvalot S. Blay JY, et al. Ann Oncol. 2019 Aug 1;30(8):1407. doi: 10.1093/annonc/mdz170. Ann Oncol. 2019. PMID: 31168580 Free PMC article. No abstract available.

Abstract

Background: NETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry.

Patients and methods: Patients' characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497).

Results: Among the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li-Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P < 0.001 for all, with a hazard ratio of 0.681 (95% CI 0.618-0.749) for OS].

Conclusion: This nationwide registry of sarcoma patients shows that surgical treatment in a reference center reduces the risk of relapse and death.

Keywords: reference center; relapse; resection; sarcoma; surgery; survival.

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Figures

Figure 1.
Figure 1.
Relapse and survival of the incident population of 29 497 patients. (A, B, C) Local relapse free survival (LRFS), event-free survival (EFS) and overall survival (OS) of patients with a final R0, R1, R2 and R unknown resection. (D, E, F) LRFS, EFS and OS of patients operated with a NETSARC center or outside a NETSARC center.
See this image and copyright information in PMC

Comment in

References

    1. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, Pathology and Genetics of Tumours of Soft Tissue and Bone. World Health Organization. Lyon: IARC Press; 2013.
    1. Ducimetière F, Lurkin A, Ranchère-Vince D. et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One 2011; 6(8): e20294. - PMC - PubMed
    1. Mastrangelo G, Fadda E, Cegolon L. et al. A European project on incidence, treatment, and outcome of sarcoma. BMC Public Health 2010; 10: 188.. - PMC - PubMed
    1. Stiller CA, Trama A, Serraino D. et al. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer 2013; 49(3): 684–695. - PubMed
    1. Casali PG, Bielack S, Abecassis N. et al. Bone sarcomas: ESMO-PaedCan-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29(Suppl 4): iv79–iv95. - PubMed

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