The nationwide cohort of 26,883 patients with sarcomas treated in NETSARC reference network between 2010 and 2015 in France: major impact of multidisciplinary board presentation prior to 1st treatment

Background

Since 2009 a network of 26 reference centres for sarcoma patients (pts) in France was designated by the French National Cancer Institute. The outcome of the 26,883 pts discussed in these 26 NETSARC multidisciplinary tumour boards (NMTB) is presented.

Methods

The NETSARC database includes pts characteristics, treatment and diagnosis procedures, progression and survival. Soft tissue, visceral, and bone sarcomas represent 17,801 (66%), 4,625 (17%), 4,457 (17%) of pts respectively. Individual NETSARC centres managed a median of 404 (range 92-2,974) pts in 5 yrs.

Results

13,845 women (52%) and 13,038 men (48%), with a median age of 60y (range 0-101) were included. Leiomyosarcoma, GIST, liposarcoma, and undifferentiated pleomorphic sarcoma were the most frequent histotypes. 11% pts had metastases at diagnosis. 37% were presented to a NMTB prior to initial treatment. The median follow-up of the series is 26 months (range 6-590). At 24 months, local and metastatic relapse rates are 24% and 22% respectively. Overall survival rate at 24 months is 87%. Local relapse rate was significantly lower in pts discussed in NMTB prior to 1st treatment (22% vs 29% at 24 months, p = 0.000), metastatic relapse rates were not significantly different. Patients discussed in NMTB prior to 1^st treatment had significantly larger tumours, higher grade, more frequently deep-seated, of head/neck or internal trunk (p = 0.000 all). In multivariate analysis, the lack of discussion in NMTB prior to initial treatment was an independent unfavourable prognostic factor for relapse (HR:1.9, 95% CI 1.6-2.2) along with age, grade, tumour size, depth and tumour location (all p values 

Conclusions

Relapse rate is higher in this large real life series of 26,883 sarcoma pts of the NETSARC network than previously published. Presentation in a MTB within a reference centre prior to first treatment is a major parameter associated with lower rate of relapse.

Clinical trial identification

Legal entity responsible for the study

Centre Léon Bérard, Lyon, France

Funding

Institut National du Cancer (INCa), France

Disclosure

All authors have declared no conflicts of interest.