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Connective Tissue Oncology Society |
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| 2001 CTOS Annual Meeting Posters— Surgery THE VALUE OF POPULATION
BASED RESEARCH IN SOFT TISSUE SARCOMA (STS) OBJECTIVE: Because of the heterogeneity and rarity of STS, Level I evidence is largely lacking and this results in a variety of treatment approaches. Population Based Outcomes Research may be of value in STS management as it is generalizable, includes and follows all patients and avoids the selection, referrer and other biases inherent in case series and even randomized study. METHODS: The Alberta Cancer Registry, by law, registers all cancers including STS, patient demographics, tumour and treatment details and overall survival. There are two Regional Cancer Centres (Tom Baker in Southern Alberta population 1.3M and the Cross Cancer Institute in Northern Alberta population 1.7M). RESULTS: Between 1990 and 1999, 380 patients (53% male; 211 Northern and 169 Southern) over the age of 18 years (mean 56 + 18 years) were diagnosed with STS. The most common tumours were MFH (30%), sarcoma NOS (27%), leiomyosarcoma (16%) and liposarcoma (15%) with no significant differences between centres. Other than pelvis n = 33 (Northern) vs. 16 (Southern) p = 0.01 and trunk n = 17 (Northern) vs. 6 (Southern) p = 0.02, tumour location was similar in Northern and Southern Alberta. Northern Alberta coded significantly more high grade tumours (41%) than Southern Alberta (18%) p 0.01. Significant treatment differences existed between Northern and Southern Alberta: surgery + radiation + chemotherapy 5% vs. 38% p 0.0001, surgery + radiation 30% vs. 11% p 0.0001, and surgery alone 46% vs. 29% p 0.0001. These differences did not result in survival differences. For limb, 5 year survival was 69% (Northern) vs. 66% (Southern) and for non-limb was 56% (Northern) vs. 52% (Southern). These differences were not significant. For the province as a whole the overall 5 year non-limb survival was 54% vs. limb 67% p = 0.0072. CONCLUSION: In summary, using a population based approach to the assessment of STS within a province, differences in treatment and tumour grade were not associated with overall survival differences. While local recurrence and quality of life data are not yet available, we concluded that this approach can provide valuable insights into the management of this complex cancer.
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