1487P - Conformity to Clinical Practices Guidelines (CPGs) in a prospective cohort of sarcoma patients managed for first diagnosis in the Rhone-Alpes Region

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Sarcoma
Presenter Pierre Heudel
Authors P. Heudel1, C. Cropet2, G. De Laroche3, P. Cousin4, P. Biron5, P. Pauwels6, F. Farsi7, D. Cellier8, J. Blay1, I.L. Ray-Coquard1
  • 1Medical Oncology, Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 2Unité De Biostatistique Et D'evaluation Des Thérapeutiques, Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 3Medical Oncology, Institut cancérologique de la Loire, Saint Priest en Jarez/FR
  • 4évaluation Des Pratiques Médicales Et Sarcome, Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 5Centre Léon Bérard, 69008 - Lyon CEDEX/FR
  • 6Oncology, Cancéropole Lyon Auvergne Rhone Alpes, Lyon/FR
  • 7Réseau, Reseau Espace Sante Cancer Rhone Alpes, Lyon/FR
  • 8Medecine, Merck Serono, Lyon/FR

Abstract

Background

A 32% adhesion to CPGs for sarcoma management was reported in a retrospective study (1). To confirm these results, we prospectively assessed the management of all patients diagnosed with sarcoma in the Rhône-Alpes French region (5.9 millions inhabitants) over 2 years. We report the long term follow-up of these patients and investigated parameters significantly correlated to compliance to CPGs.

Methods

From March 2005 to February 2007, all patients, over 18 years, diagnosed with localized sarcoma in Rhone-Alpes were included and collected through collaboration with all 143 pathologists of this region. No specific dedicated CPGs, are available for patients with Kaposi sarcoma, chondrosarcoma, Ewing sarcoma/PNET and desmoid fibromatosis; these were therefore excluded.

Results

634 patients with localized sarcoma were included (soft tissue sarcoma (STS): n = 472; GIST: n = 129; bone primary site: n = 33) for a total incidence of 6.2 /100000/year. Taking into account all parameters defining management (initial diagnosis until follow up), overall conformity to CPGs was only 40%, ranging from 54% for GIST to 36 % for STS. In univariate analysis, adhesion to CPGs for primary management varied according to primary tumor site and hospital. Localization was found to be specifically correlated to compliance to the CPGs concerning initial diagnosis (56% of patients were conformed for limb vs. 71% for trunk localization; P = <0.001) and first surgery (53% conform for limb vs. 70% for trunk; P = <0.001). Sarcoma management realized in comprenhensive cancer center or dedicated university hospital, reported significant statistical better conformity to CPGs than general or private structures. This conformity is better at all stages of management (table).

Adhesion to CPGs Universitary or cancer hospital Private or general hospital Chi-2 test
-Diagnostic procedures 83.5% 54.2% <0.001
-Surgery 81.2% 54.7% <0.001
-Follow up 94.5% 76.1% <0.001

Conclusions

Conformity to CPGs for initial management of sarcoma was observed in 40% of patients only. Adhesion to CPGs is significantly superior in sarcoma-dedicated cancer center. (1) Ray coquard et al, Ann Oncol. 2004;15:307-15

Disclosure

All authors have declared no conflicts of interest.