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. 2025 Mar:43:100530.
doi: 10.1016/j.jcpo.2024.100530. Epub 2024 Dec 11.

Breaking barriers: The impact of telemedicine on improving soft tissue and bone tumor management in Armenia

Ruzanna Papyan  1 , Shushan Hovsepyan  2 , Julieta Hoveyan  3 , Saten Hovhannisyan  4 , Tatev Arakelyan  5 , Gevorg Tamamyan  2 , Lilit Sargsyan  4 , Lusine Hakobyan  4 , Levon Davtyan  6 , Armine Lazaryan  7 , Davit Dallakyan  8 , Narek Manukyan  9 , Armen Mkhitaryan  10 , Nelli Grigoryan  9 , Sybille Perkowski  11 , Birgit Froehlich  12 , Andreas Groll  12 , Manfred Schiborr  13 , Katja Glutig  13 , Kai Kroeger  14 , Niklas Deventer  15 , Marieke Mathilda Vaal  15 , Karsten Wiebe  16 , Joerg Haier  16 , Wolfgang Hartmann  17 , Eva Wardelmann  18 , Monika Scheer  19 , Heribert Jürgens  12
Affiliations

Breaking barriers: The impact of telemedicine on improving soft tissue and bone tumor management in Armenia

Ruzanna Papyan et al. J Cancer Policy. 2025 Mar.

Abstract

Purpose: Musculoskeletal sarcomas are a rare group of malignant neoplasms, accounting for approximately 12 % of all malignant neoplasms among children. Childhood cancer outcomes vary between developed and developing countries due to financial and educational inequalities. Telemedicine programs have a huge impact on the quality of cancer care, helping to optimize resources for better cancer care in a resource-limited setting. In 2019, Armenia established multidisciplinary teams (MDT) with the guidance of international experts via telemedicine, significantly improving patients' management diagnosed with sarcomas.

Methods: The musculoskeletal cancer working group, mentored by the University Hospital of Münster (UKM), conducted weekly virtual tumor boards to discuss cases, focusing on the review of pathological and radiological examinations.

Results: From August 2019 to December 2023, the musculoskeletal cancer MDT discussed 151 musculoskeletal tumor cases via 74 MDT meetings. Imaging studies of all discussed cases were reviewed, while the review of histology images was performed for 93 % of cases. The pathology review led to changes in previously established diagnoses in eleven cases, which subsequently changed management. These led to altered local control strategies for 32 patients, with 5 requiring treatment abroad, and changes in chemotherapy regimens for 17 patients. Notably, there were no cases of treatment refusal post-implementation, a reduction from the previous 3 % refusal rate.

Conclusion: The successful telemedicine initiative, coupled with institutional support, improved the care of patients diagnosed with musculoskeletal tumors. The investment in telemedicine in developing countries not only enhances communications with international and local experts across various disciplines but also significantly improves the handling of patients diagnosed with sarcomas.

Keywords: Bone sarcoma; Low-resource setting; Remote healthcare; Soft tissue sarcoma; Telemedicine.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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