S Bonvalot1, E Gaignard2, E Stoeckle3, P Meeus4, G Decanter5, S Carrere6, C Honore7, J B Delhorme8, M Fau9, D Tzanis2, S Causeret10, P Gimbergues11, J M Guillois12, B Meunier13, A Le Cesne14, F Ducimetiere15, M Toulmonde16, J Y Blay17. 1. Department of Surgery, Institut Curie, PSL University, Paris, France. sylvie.bonvalot@curie.fr. 2. Department of Surgery, Institut Curie, PSL University, Paris, France. 3. Department of Surgery, Institut Bergonié, Bordeaux, France. 4. Department of Surgery, Centre Léon Bérard, Lyon, France. 5. Department of Surgery, Centre Oscar Lambret, Lille, France. 6. Department of Surgery, Institut du Cancer Val d'Aurelle, Montpellier, France. 7. Department of Surgery, Gustave Roussy Cancer Campus, Villejuif, France. 8. Department of Surgery, CHRU de Hautepierre, Strasbourg, France. 9. Department of Surgery, Institut de Cancérologie de Lorraine, Nancy, France. 10. Department of Surgery, Centre Georges-François Leclerc, Dijon, France. 11. Department of Surgery, Centre Jean Perrin, Clermont-Ferrand, France. 12. Department of Surgery, Centre François Baclesse, Caen, France. 13. Department of Surgery, CHU Pontchaillou, Rennes, France. 14. Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France. 15. Equipe Evaluation Médicale et Sarcome (EMS), Centre Léon Bérard, Lyon, France. 16. Department of Medical Oncology, Institut Bergonié, Bordeaux, France. 17. Department of Medical Oncology, Centre Léon Bérard, Lyon, France.
Abstract
BACKGROUND: Guidelines recommend that retroperitoneal sarcoma (RPS) be managed in a reference sarcoma center (RSC), but the benefit remains to be demonstrated. This study investigated the impact of initial surgery performed within the NetSarc network on overall survival (OS). METHODS: NetSarc is a network of 26 RSCs with specialized multidisciplinary tumor boards (MDTs) that is funded by the French NCI. Since 2010, presentation to an MDT and second pathological review are mandatory for sarcoma patients, and data have been collected in a nationwide database. We extracted data for all patients who received surgery in or outside the network and who presented at a NetSarc center (NSC) for primary nonmetastatic RPS between 2010 and 2017. RESULTS: A total of 2945 patients were included: 1078 (36.6%) underwent the first surgery in an NSC, and 1867 (63.4%) in an out-of-network center. The median number of operations at an NSC during the study period was 23 (range: 3-209), and the corresponding median was 1 (range: 1-2) at out-of-network centers. The diagnostic procedures followed significantly more clinical practice guidelines within NetSarc, where there were significantly more first R0 resections [452 (41.9%) vs. 230 (12.3%)]. The OS was significantly superior for patients treated within NetSarc, with a 2-year OS of 87% vs. 70% (p < 0.001). In the multivariate analysis, surgery within an NSC was an independent predictor of OS, with a twofold lower odds ratio of death. CONCLUSIONS: In this national study, surgery for primary RPS within an NSC was associated with a better OS.
BACKGROUND: Guidelines recommend that retroperitoneal sarcoma (RPS) be managed in a reference sarcoma center (RSC), but the benefit remains to be demonstrated. This study investigated the impact of initial surgery performed within the NetSarc network on overall survival (OS). METHODS: NetSarc is a network of 26 RSCs with specialized multidisciplinary tumor boards (MDTs) that is funded by the French NCI. Since 2010, presentation to an MDT and second pathological review are mandatory for sarcomapatients, and data have been collected in a nationwide database. We extracted data for all patients who received surgery in or outside the network and who presented at a NetSarc center (NSC) for primary nonmetastatic RPS between 2010 and 2017. RESULTS: A total of 2945 patients were included: 1078 (36.6%) underwent the first surgery in an NSC, and 1867 (63.4%) in an out-of-network center. The median number of operations at an NSC during the study period was 23 (range: 3-209), and the corresponding median was 1 (range: 1-2) at out-of-network centers. The diagnostic procedures followed significantly more clinical practice guidelines within NetSarc, where there were significantly more first R0 resections [452 (41.9%) vs. 230 (12.3%)]. The OS was significantly superior for patients treated within NetSarc, with a 2-year OS of 87% vs. 70% (p < 0.001). In the multivariate analysis, surgery within an NSC was an independent predictor of OS, with a twofold lower odds ratio of death. CONCLUSIONS: In this national study, surgery for primary RPS within an NSC was associated with a better OS.
Authors: William W Tseng; Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Samuel J Ford; Ricardo J Gonzalez; Rebecca A Gladdy; David E Gyorki; Mark Fairweather; Kyo Won Lee; Markus Albertsmeier; Winan J van Houdt; Magalie Fau; Carolyn Nessim; Giovanni Grignani; Kenneth Cardona; Vittorio Quagliuolo; Valerie Grignol; Jeffrey M Farma; Elisabetta Pennacchioli; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Max L Almond; John E Mullinax; Wendy Johnston; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Anant Desai; Rachel Voss; Roberta Sanfilippo; Robin L Jones; Elizabeth H Baldini; Andrew J Wagner; Charles N Catton; Silvia Stacchiotti; Khin Thway; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2022-06-29 Impact factor: 4.339
Authors: Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Anant Desai; Rebecca A Gladdy; Ricardo Gonzalez; David E Gyorki; Mark Fairweather; Winan J van Houdt; Eberhard Stoeckle; Jae Berm Park; Markus Albertsmeier; Carolyn Nessim; Kenneth Cardona; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Samuel J Ford; Deanna Ng; John E Mullinax; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Silvia Stacchiotti; Robin L Jones; Thomas DeLaney; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2021-04-14 Impact factor: 4.339
Authors: J-Y Blay; P Casali; C Bouvier; C Dehais; I Galloway; J Gietema; J Halámková; N Hindi; A Idbaih; E Kinloch; H-J Klümpen; T Kolarova; K Kopeckova; J Lovey; M Magalhaes; K Oselin; S Piperno-Neumann; A Ravnsbaek; M Rogasik; A Safwat; S Scheipl; M Seckl; J Taylor; M Temnyk; A Trama; M Urbonas; M Wartenberg; A Weinman Journal: ESMO Open Date: 2021-06-14