1488P - Organisation of sarcoma patient management in reference centers in NETSARC network: analysis of the quality of resection

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Sarcoma
Surgery and/or Radiotherapy of Cancer
Presenter Sylvie Bonvalot
Authors S. Bonvalot1, P. Meeus2, E. Stoeckle3, B. Bui4, A. Le Cesne5, .6, I.L. Ray-Coquard7, J. Coindre8, C. Chemin9, J. Blay, On Behalf Of The Netsarc National Network (www.netsarc.org)7
  • 1Department Of Surgery, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 2Surgery, Centre Léon Bérard, 69008 - Lyon/FR
  • 3Surgery, Institute Bergonie, FR-33076 - Bordeaux CEDEX/FR
  • 4Medical Oncology, Institute Bergonie, FR-33076 - Bordeaux CEDEX/FR
  • 5Institut Gustave Roussy, 94805 - VILLEJUIF/FR
  • 6Medical Oncology, Centre Oscar Lambret, 59020 - Lille/FR
  • 7Medical Oncology, Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 8Anatomopathology, Institute Bergonie, FR-33076 - Bordeaux CEDEX/FR
  • 9Centre Léon Berard, 69008 - Lyon/FR

Abstract

The French National Cancer Institute suggested the improvement of sarcoma management when performed in a multidisplinary expert team. Since 2009, a network of 26 reference multidisciplinary boards has been created to improve the quality of care of sarcoma patients in France. All patient cases presented are uploaded in the NetSarc network collecting patient characteristics, clinical situation at the time of the discussion, medical decision, and patient outcome (survival and relapse).

Patients and methods

From January 2010 to April 2012, 8934 patients were included on this database. Patients were presented from centers within (N = 5911, 66%) or outside (N = 2343, 26%) the Netsarc Network (parameter unknown in N = 679, 8% patient). Patient and disease characteristics and treatment results are described.

Results

There were 4662 women (52%) and 4272 men (48%). Median size of the sarcoma was 95mm (range2- > 400). Soft tissue, visceral, and bone represented 6381 (71%) 1285 (14%) and 1264 (14%) of patients respectively. In soft tissue tumours, grade 1, 2, 3 were reported in 44%, 33%, 23% of patients. The most frequent histological subtypes were leiomyosarcomas (all sites) (n = 769, 9%), GIST (558, 6%), dedifferentiated liposarcomas (n = 439, 5%). Most frequent primary sites were thigh (1268, 14%), retroperitoneal (796, 9%), thoracic wall (460, 5%), uterus (405, 4.5%), legs (325, 4%). 1052 (11%) patients were reported to have metastases. Clinical and disease status at the time of discussion was prior to: biopsy (N = 824, 9%), first surgery (N = 1751, 20%), adjuvant treatment (N = 2806, 31%). 6161 (67%) patients had a surgery, n = 1472 (24%) in the Netsarc network and outside n = 1843 (30%); in n = 2846 (46%) this information is not still documented. Patients whose primary surgery was performed in Netsarc centers had R0, R1, R2, and fragmented primary surgery in 61%, 31%, 5%, 2% vs 37%, 40%, 16%, 7% in primary care centers non-Netsarc centers (p < 0.000001).

Conclusions

This first analysis of the NetSarc database shows that more patients had optimal surgery in reference centers than in primary care centers. This tool will ensure the monitoring of dedicated action to improve the management of sarcoma patients in the future.

Disclosure

All authors have declared no conflicts of interest.