OBJECTIVE: : To define the prognostic significance of surgical center case volume on outcome for soft tissue sarcoma (STS). METHODS: : STS cases registered in the Florida Cancer Data System (FCDS) between 1981 and 2001 were analyzed. Medical facilities were ranked by STS operative volume. Facilities above the 67th percentile for volume were defined as high-volume centers (HVCs). RESULTS: : Of the 4205 operative cases of STS identified, 68.1% were treated at low-volume centers (LVCs) and 31.9% at HVCs. A larger proportion of high-grade tumors (53.8% vs. 44.3%) and lesions over 10 cm (40.7% vs. 28.7%) were resected at HVC (P < 0.001). The 30-day mortality was 0.7% for HVC and 1.5% for LVC (P = 0.028), and mortality rates at 90 days were 1.6% and 3.6%, respectively (P = 0.001). Median survival was 40 months at HVC and 37 months at LVC (P = 0.002). Univariate analysis demonstrated significantly improved survival at HVC for high-grade tumors (median 30 months vs. 24 months, P = 0.001), lesions over 10 cm (28 months vs. 19 months, P = 0.001) and truncal or retroperitoneal sarcomas (39 months vs. 31 months, P = 0.011). Limb amputation rate was lower (9.4% vs. 13.8%, P = 0.048) and radiation and chemotherapy were more frequently administered at HVC (OR = 1.54). On multivariate analysis, treatment at a HVC was a significant independent predictor of improved survival (OR = 1.292, P = 0.047). CONCLUSIONS: : STS patients treated at HVC have significantly better survival and functional outcomes. Patients with either large (>10 cm), high-grade or truncal/retroperitoneal tumors should be treated exclusively at a high-volume center.
OBJECTIVE: : To define the prognostic significance of surgical center case volume on outcome for soft tissue sarcoma (STS). METHODS: : STS cases registered in the Florida Cancer Data System (FCDS) between 1981 and 2001 were analyzed. Medical facilities were ranked by STS operative volume. Facilities above the 67th percentile for volume were defined as high-volume centers (HVCs). RESULTS: : Of the 4205 operative cases of STS identified, 68.1% were treated at low-volume centers (LVCs) and 31.9% at HVCs. A larger proportion of high-grade tumors (53.8% vs. 44.3%) and lesions over 10 cm (40.7% vs. 28.7%) were resected at HVC (P < 0.001). The 30-day mortality was 0.7% for HVC and 1.5% for LVC (P = 0.028), and mortality rates at 90 days were 1.6% and 3.6%, respectively (P = 0.001). Median survival was 40 months at HVC and 37 months at LVC (P = 0.002). Univariate analysis demonstrated significantly improved survival at HVC for high-grade tumors (median 30 months vs. 24 months, P = 0.001), lesions over 10 cm (28 months vs. 19 months, P = 0.001) and truncal or retroperitoneal sarcomas (39 months vs. 31 months, P = 0.011). Limb amputation rate was lower (9.4% vs. 13.8%, P = 0.048) and radiation and chemotherapy were more frequently administered at HVC (OR = 1.54). On multivariate analysis, treatment at a HVC was a significant independent predictor of improved survival (OR = 1.292, P = 0.047). CONCLUSIONS: : STS patients treated at HVC have significantly better survival and functional outcomes. Patients with either large (>10 cm), high-grade or truncal/retroperitoneal tumors should be treated exclusively at a high-volume center.
Authors: Caprice K Christian; Michael L Gustafson; Rebecca A Betensky; Jennifer Daley; Michael J Zinner Journal: World J Surg Date: 2005-10 Impact factor: 3.352
Authors: Lloyd A Mack; Phil J Crowe; Jia Lin Yang; Norman S Schachar; Don G Morris; Elizabeth C Kurien; Claire L F Temple; Robert L Lindsay; Enzio Magi; William G DeHaas; Walley J Temple Journal: Ann Surg Oncol Date: 2005-06-20 Impact factor: 5.344
Authors: Alexander Stojadinovic; Denis H Y Leung; Peter Allen; Jonathan J Lewis; David P Jaques; Murray F Brennan Journal: J Clin Oncol Date: 2002-11-01 Impact factor: 44.544
Authors: Ernest C Borden; Laurence H Baker; Robert S Bell; Vivien Bramwell; George D Demetri; Burton L Eisenberg; Christopher D M Fletcher; Jonathan A Fletcher; Marc Ladanyi; Paul Meltzer; Brian O'Sullivan; David R Parkinson; Peter W T Pisters; Scott Saxman; Samuel Singer; Murali Sundaram; Allan T van Oosterom; Jaap Verweij; Jill Waalen; Sharon W Weiss; Murray F Brennan Journal: Clin Cancer Res Date: 2003-06 Impact factor: 12.531
Authors: Holger Bannasch; Steffen U Eisenhardt; Anca-Ligia Grosu; Jürgen Heinz; Arash Momeni; G Björn Stark Journal: Dtsch Arztebl Int Date: 2011-01-21 Impact factor: 5.594
Authors: Tristan Boam; Andreas Hueschelrath; Ly Tho; Thomas Mendes da Costa; Anne McMurrey; James Gollogly Journal: World J Surg Date: 2016-07 Impact factor: 3.352
Authors: S Mathoulin-Pélissier; C Chevreau; C Bellera; E Bauvin; M Savès; P Grosclaude; S Albert; J Goddard; S Le Guellec; M Delannes; B N Bui; J Mendiboure; E Stoeckle; J M Coindre; G Kantor; M Kind; A Cowppli-Bony; S Hoppe; A Italiano Journal: Ann Oncol Date: 2013-11-26 Impact factor: 32.976
Authors: Alexander L Lazarides; David L Kerr; Daniel P Nussbaum; R Timothy Kreulen; Jason A Somarelli; Dan G Blazer; Brian E Brigman; William C Eward Journal: Clin Orthop Relat Res Date: 2019-04 Impact factor: 4.176