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• W2946749587 abstract "Soft tissue sarcomas (STS) represent a rare and heterogeneous group of tumors. We sought to characterize national trends in referral patterns, treatment strategies, and overall survival (OS) over the course of a decade. Adult patients with extra-abdominal STS were identified using the National Cancer Database and categorized by diagnosis year (2005–2009 and 2010–2014). High-volume hospitals (HVH) were defined as those >90th percentile in volume of STS patients treated, and others were defined as low-volume hospitals (LVH). Standard statistical methods were used to compare treatment strategies and OS by diagnosis period. Of 55,212 patients, 25,469 (46.1%) were diagnosed in 2005–2009 and 29,743 (53.9%) in 2010–2014. Despite increased utilization of neoadjuvant radiation therapy (26.6% vs. 34.8%, P < 0.001), the rate of R0 resections did not change (75.0% vs. 74.8%, P = 0.067). Furthermore, at a national level, OS did not improve over time (HR 0.99, 95% CI 0.96–1.01). When outcomes were stratified by volume, treatment at HVH compared to LVH was associated with improved rates of R0 resection (OR 1.27, 95% CI 1.20–1.35) and OS (HR 0.92, 95% CI 0.89–0.95). Moreover, there was a modest improvement in OS at HVH (HR 0.95, 95% CI 0.91–1.00), but not at LVH (HR 1.01, 95% CI 0.97–1.04). However, referral to HVH did not change over time (40.7% vs. 40.7%, P = 0.91). OS for STS did not change at a national level over the course of a decade, although it improved at HVH. Further outcome improvements will likely require more effective systemic therapies." @default.
• W2946749587 created "2019-05-29" @default.
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• W2946749587 date "2019-06-01" @default.
• W2946749587 modified "2023-10-18" @default.
• W2946749587 title "Trends in practice patterns and outcomes: A decade of sarcoma care in the United States" @default.
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• W2946749587 doi "https://doi.org/10.1016/j.suronc.2019.05.018" @default.
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