Author:
Kubicek Pierre,Cesne Axel Le,Lervat Cyril,Toulmonde Maud,Chevreau Christine,Duffaud Florence,Le Nail Louis-Romée,Morelle Magali,Gaspar Nathalie,Vérité Cécile,Castex Marie-Pierre,Penel Nicolas,Saada Esma,Causeret Sylvain,Bertucci François,Perrin Christophe,Bompas Emmanuelle,Orbach Daniel,Laurence Valérie,Piperno-Neumann Sophie,Anract Philippe,Rios Maria,Gentet Jean-Claude,Mascard Éric,Pannier Stéphanie,Blouin Pascale,Carrère Sébastien,Chaigneau Loïc,Soibinet-Oudot Pauline,Corradini Nadège,Boudou-Rouquette Pascaline,Ruzic Jean-Christophe,Lebrun-Ly Valérie,Dubray-Longeras Pascale,Varatharajah Sharmini,Lebbe Céleste,Ropars Mickaël,Kurtz Jean-Emmanuel,Guillemet Cécile,Lotz Jean-Pierre,Berchoud Juliane,Cherrier Grégory,Ducimetière Françoise,Chemin Claire,Italiano Antoine,Honoré Charles,Desandes Emmanuel,Blay Jean-Yves,Gouin François,Marec-Bérard Perrine
Abstract
Abstract
Background
The initial management of patients with sarcoma is a critical issue. We used the nationwide French National Cancer Institute-funded prospective sarcoma database NETSARC to report the management and oncologic outcomes in adolescents and young adults (AYAs) patients with sarcoma at the national level.
Patients and methods
NETSARC database gathers regularly monitored and updated data from patients with sarcoma. NETSARC was queried for patients (15–30 years) with sarcoma diagnosed from 2010 to 2017 for whom tumor resection had been performed. We reported management, locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) in AYA treated in French reference sarcoma centers (RSC) and outside RSC (non-RSC) and conducted multivariable survival analyses adjusted for classical prognostic factors.
Results
Among 3,227 patients aged 15–30 years with sarcoma diagnosed between 2010 and 2017, the study included 2,227 patients with surgery data available, among whom 1,290 AYAs had been operated in RSC, and 937 AYAs in non-RSC. Significant differences in compliance to guidelines were observed including pre-treatment biopsy (RSC: 85.9%; non-RSC 48.1%), pre-treatment imaging (RSC: 86.8%; non-RSC: 56.5%) and R0 margins (RSC 57.6%; non-RSC: 20.2%) (p < 0.001). 3y-OS rates were 81.1% (95%CI 78.3–83.6) in AYA in RSC and 82.7% (95%CI 79.4–85.5) in AYA in non-RSC, respectively. Whereas no significant differences in OS was observed in AYAs treated in RSC and in non-RSC, LRFS and PFS were improved in AYAs treated in RSC compared to AYAs treated in non-RSC (Hazard Ratios (HR): 0.58 and 0.83, respectively).
Conclusions
This study highlights the importance for AYA patients with sarcoma to be managed in national sarcoma reference centers involving multidisciplinary medical teams with paediatric and adult oncologists.
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
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