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. 2025 Sep:247:116319.
doi: 10.1016/j.amjsurg.2025.116319. Epub 2025 Mar 26.

Impact of fragmented care on retroperitoneal sarcomas

Denise L Wong  1 , Jordan Fredette  2 , Jill Hasler  2 , Andrea S Porpiglia  3 , Stephanie H Greco  3 , Sanjay S Reddy  3 , Jeffrey M Farma  3 , Anthony M Villano  3
Affiliations

Impact of fragmented care on retroperitoneal sarcomas

Denise L Wong et al. Am J Surg. 2025 Sep.

Abstract

Background: Fragmented care (FC) is associated with mixed outcomes. This analysis examines FC's impact on retroperitoneal sarcoma (RPS) treatment.

Methods: The National Cancer Database was queried for adult patients with non-metastatic, surgically-resected RPS. FC was defined as diagnosis/treatment at >1 facility. Univariable and multivariable analyses examined factors associated with FC and its impact on overall survival.

Results: 4976 patients were included; 45.6 ​% experienced FC. Non-FC and FC cohorts were similar. Dedifferentiated liposarcoma were more common in FC cohort, as were poorly differentiated and undifferentiated tumors (p ​< ​0.05). FC cohort had greater travel distance and time-to-treatment (both p ​< ​0.001). Variables independently associated with FC included urban and rural setting and histology (poorly differentiated and undifferentiated) (all p ​< ​0.05). After controlling for other variables, FC was not associated with survival.

Conclusion: FC patients experienced longer distance travelled and time-to-treatment without survival impact. National emphasis must be placed on broadening access to equitable, high-quality sarcoma care.

Keywords: Fragmented care; NCDB; Retroperitoneal sarcoma.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no conflicts of interest. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA006927. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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