1477O - Adhesion to clinical practices guidelines (CPGs) and role on survival for soft tissue sarcoma patients. Analysis of a population based cohort from R...

Date 30 September 2012
Event ESMO Congress 2012
Session Sarcoma
Topics Soft Tissue Sarcomas
Presenter Olfa Derbel
Authors O. Derbel1, C. Cropet2, P. Meeus1, F. Gilly3, G. Vaz4, P. Thiesse3, D. Cellier5, D. Vince-Ranchere1, J. Blay1, I.L. Ray-Coquard6
  • 1Medical Oncology, centre Léon Bérard, 69008 - Lyon/FR
  • 2Unité De Biostatistique Et D'evaluation Des Thérapeutiques, Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 3Medical Oncology, Université Claude Bernard, 69008 - Lyon/FR
  • 4Surgical Oncology, hopital Edouard Herriot, 69008 - lyon/FR
  • 5Medecine, Merck Serono, Lyon/FR
  • 6Oncology, Centre Leon Berard, Lyon/FR

 

Abstract

Sarcoma treatment has been suggested to be improved by the management in a multidisplinary expert team and adhesion to CPG's (ann oncol 04). To confirm the strong relation between medical practices and survival, an exhaustive analysis of the outcome of the sarcoma patients population was performed in the Rhône–Alpes region.

Patients and methods

From March 2005 to February 2007, 634 patients > 18 years old, diagnosed with localized sarcoma in Rhone-Alpes were included (Soft tissue sarcoma (STS): n = 472; GIST: n = 129; bone primary site: n = 33). Adhesion to national CPG's was analysed for all patients. Prognostic impact of conformity to CPG's on overall survival (OS) and progression free survival (PFS) was analyzed for STS patients, in in a univariate analysis and a Cox model regression.

Results

Institutional records of 472 patients with localized STS sarcoma were reviewed., The sex ratio (male/female) was 1.1 and varied with the type of sarcoma. The median age was 60 years (range from 18 to 92).The most frequent histological subtypes were liposarcoma (N= 133, 28%), unclassified sarcoma (N= 98, 20.7%), and leiomyosarcoma (N= 70, 14.8%). Conformity to CPGs for patients with localized sarcoma was 40, 62, 87, 94 and 82% for global conformity, initial surgery, radiation therapy, chemotherapy and follow-up, respectively. In multivariate analysis, conformity of surgery to CPG's was an independent prognostic factor of PFS in patients with STS, along with age at diagnosis, grade and histological subtype (HR: 0.5, 95%CI: 0.36-0.67) (p < 0.0001). Conformity of surgery (HR: 2.6), Age (HR: 1.07) and grade (HR: 0.06) are independents factors for overall survival in multivariate analysis for patients with liposarcomas.

Conclusion

Conformity to CPG's improves progression free survival for sarcoma patients. Conformity of surgical procedure to CPG's is a major independent factor predicting PFS for STS patients and OS for patients with liposarcomas.

Disclosure

All authors have declared no conflicts of interest.