Survival Benefit of the Surgical Management of Retroperitoneal Sarcoma in a Reference Center: A Nationwide Study of the French Sarcoma Group from the NetSarc Database
Survival Benefit of the Surgical Management of Retroperitoneal Sarcoma in a Reference Center: A Nationwide Study of the French Sarcoma Group from the NetSarc Database
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DOI：
10.1245/s10434-019-07421-9
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发表时间：
2019-07-01
影响因子：
3.7
通讯作者：
Blay, J. Y.
中科院分区：
文献类型：
--
作者：
Bonvalot, S.;Gaignard, E.;Blay, J. Y.
背景指南建议腹膜后肉瘤（RPS）在参考肉瘤中心（RSC）进行治疗，但其益处仍有待证实。本研究调查了在NetSarc网络内进行的初始手术对总生存率（OS）的影响。NetSarc是一个由26个RSC组成的网络，拥有由法国NCI资助的专业多学科肿瘤委员会（MDT）。自2010年以来，对肉瘤患者进行MDT和第二次病理审查是强制性的，数据已收集到全国数据库中。我们提取了2010年至2017年期间在网络内外接受手术并在NetSarc中心（NSC）接受原发性非转移性RPS的所有患者的数据。共纳入2945例患者：1078例（36.6%）在NSC接受首次手术，1867例（63.4%）在网络外中心接受首次手术。研究期间，NSC的中位手术次数为23次（范围：3-209次），网络外中心的相应中位手术次数为1次（范围：1-2次）。NetSarc中的诊断程序遵循的临床实践指南明显更多，首次R 0切除明显更多[452例（41.9%）vs. 230例（12.3%）]。在NetSarc内接受治疗的患者的OS显着上级，2年OS分别为87%和70%（p
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