2002 CTOS Annual Meeting Oral Presentations — Surgery

SHOULD SOFT TISSUE SARCOMAS BE TRAETED AT A SPECIALIST CENTRE?
[Abstract ID: 48]

Category: Surgery

Presentation: Oral

Authors: Robert Grimer¹, Aneel Bhangu¹, John Beard¹

Author Institutions: ¹Royal Orthopaedic Hospital, United Kingdom

Presenter: Robert Grimer
rob.grimer@btopenwold.com

Correspondent: Robert Grimer
rob.grimer@btopenworld.com
Birmingham United Kingdom B31 2AP
Ph: (+44) 121 685 4150
Fax: (+44) 121 685 4146

Objectives: We have investigated whether there is evidence that patients with soft tissue sarcomas do better if treated in a specialist centre compared with district general hospitals.

Methods: We analysed the outcomes for all patients with soft tissue sarcomas in one health region of the UK over a 3 year period, with minimum follow up of 5 years. We have investigated appropriateness of treatment, adequacy of surgery, and outcomes in terms of local control and overall survival. Results are stratified for known risk factors for local control and survival (grade, depth and size).

Results: 260 patients were diagnosed as having STS over the 3 year period of whom 37% had the majority of treatment at the specialist centre under the care of 2 surgeons, whilst the other 63% were treated at a total of 38 different hospitals. Local recurrence rates were 20% at the specialist centre and 37% at the general hospitals. Overall survival was 58% at five years and was related to grade, depth and size of tumour. Patients treated at the specialist centre had larger tumours (10.3 vs 7.3cm) with a higher proportion of deep and high grade tumours. Overall survival at the two centres was identical but when stratified for known risk factors the survival rate was 1.6 times better at the specialist centre, this difference being especially obvious for Stage III tumours (p = 0.009).

Conclusions: Soft tissue sarcomas are rare. Centralization of treatment, especially for high garde tumours improves survival, local control and patients care.