Patterns of Perioperative Treatment and Survival of Localized, Resected, Intermediate- or High-Grade Soft Tissue Sarcoma: A 2000–2017 Netherlands Cancer Registry Database Analysis

Background. Standard therapy for localized soft tissue sarcoma (STS) is wide, limb-sparing resection. For intermediate- or high-grade tumors, (neo)adjuvant therapies are frequently added to the treatment plan. In this study, data from a Dutch nationwide database are used to (1) assess whether periop...

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Published in:Sarcoma 2021, Vol.2021, p.1-8
Main Authors: Van Meekeren, Milan, Fiocco, Marta, Ho, Vincent K. Y., Bovée, Judith V. M. G., Gelderblom, Hans, Haas, Rick L.
Format: Article
Language:English
Subjects:
Adjuvant treatment
Age
Analysis
Cancer
Cancer therapies
Chemotherapy
Diagnosis
Liposarcoma
Medical prognosis
Patients
Prognosis
Radiation therapy
Sarcoma
Soft tissue sarcoma
Surgery
Survival
Tumors
Variables
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container_title Sarcoma
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creator Van Meekeren, Milan
Fiocco, Marta
Ho, Vincent K. Y.
Bovée, Judith V. M. G.
Gelderblom, Hans
Haas, Rick L.
description Background. Standard therapy for localized soft tissue sarcoma (STS) is wide, limb-sparing resection. For intermediate- or high-grade tumors, (neo)adjuvant therapies are frequently added to the treatment plan. In this study, data from a Dutch nationwide database are used to (1) assess whether perioperative management of STS follows ESMO guidelines, (2) characterize prognostic factors for overall survival (OS), and (3) assess the association between perioperative treatment and survival. Methods. All intermediate- or high-grade, localized STS cases, who have undergone surgery and diagnosed between 2000 and 2017, were identified in the Netherlands Cancer Registry (NCR) database. Variables with demographic, treatment, and survival data were obtained. Survival curves were estimated by Kaplan–Meier’s method, and the effect of prognostic factors on OS was assessed in a multivariable Cox regression analysis. Results. A total of 4957 patients were identified. There were slightly more males (54.7%). Median age at diagnosis was 64 years, and 53.6% of the tumors were located in the extremities. Radiotherapy (RT) was administered to 2481 (50.1%) patients, and 252 (5.1%) patients were treated with perioperative systemic chemotherapy. The total use of perioperative RT did not significantly change in the last 20 years, but the timing followed clinical guidelines: preoperative RT increased significantly (2000–2008: 3.7%, 2009–2017: 22.3%; p
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Y. ; Bovée, Judith V. M. G. ; Gelderblom, Hans ; Haas, Rick L.</creator><contributor>Honoki, Kanya ; Kanya Honoki</contributor><creatorcontrib>Van Meekeren, Milan ; Fiocco, Marta ; Ho, Vincent K. Y. ; Bovée, Judith V. M. G. ; Gelderblom, Hans ; Haas, Rick L. ; Honoki, Kanya ; Kanya Honoki</creatorcontrib><description>Background. Standard therapy for localized soft tissue sarcoma (STS) is wide, limb-sparing resection. For intermediate- or high-grade tumors, (neo)adjuvant therapies are frequently added to the treatment plan. In this study, data from a Dutch nationwide database are used to (1) assess whether perioperative management of STS follows ESMO guidelines, (2) characterize prognostic factors for overall survival (OS), and (3) assess the association between perioperative treatment and survival. Methods. All intermediate- or high-grade, localized STS cases, who have undergone surgery and diagnosed between 2000 and 2017, were identified in the Netherlands Cancer Registry (NCR) database. Variables with demographic, treatment, and survival data were obtained. Survival curves were estimated by Kaplan–Meier’s method, and the effect of prognostic factors on OS was assessed in a multivariable Cox regression analysis. Results. A total of 4957 patients were identified. There were slightly more males (54.7%). Median age at diagnosis was 64 years, and 53.6% of the tumors were located in the extremities. Radiotherapy (RT) was administered to 2481 (50.1%) patients, and 252 (5.1%) patients were treated with perioperative systemic chemotherapy. The total use of perioperative RT did not significantly change in the last 20 years, but the timing followed clinical guidelines: preoperative RT increased significantly (2000–2008: 3.7%, 2009–2017: 22.3%; p&lt;0.001), whereas the use of postoperative RT diminished (2000–2008: 45.9%, 2009–2017: 26.1%; p&lt;0.001). The use of perioperative chemotherapy slightly decreased (2000–2008: 5.9%, 2009–2017: 4.4%; p = 0.015). 5-year OS was 59.6% (95% CI: 58.2–61.0). Sex, age, year of diagnosis, tumor location, tumor size, histological grade, depth, histological subtype, surgical margins, and the use of perioperative RT were identified as independent predictors for OS. Conclusion. Preoperative RT is gradually replacing postoperative RT for localized STS in the Netherlands. The use of perioperative chemotherapy is rare and has slightly decreased in recent years. Identified baseline characteristics and treatment factors predicting OS may aid in future treatment decisions.</description><identifier>ISSN: 1357-714X</identifier><identifier>EISSN: 1369-1643</identifier><identifier>DOI: 10.1155/2021/9976122</identifier><identifier>PMID: 34335076</identifier><language>eng</language><publisher>New York: Hindawi</publisher><subject>Adjuvant treatment ; Age ; Analysis ; Cancer ; Cancer therapies ; Chemotherapy ; Diagnosis ; Liposarcoma ; Medical prognosis ; Patients ; Prognosis ; Radiation therapy ; Sarcoma ; Soft tissue sarcoma ; Surgery ; Survival ; Tumors ; Variables</subject><ispartof>Sarcoma, 2021, Vol.2021, p.1-8</ispartof><rights>Copyright © 2021 Milan Van Meekeren et al.</rights><rights>COPYRIGHT 2021 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2021 Milan Van Meekeren et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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All intermediate- or high-grade, localized STS cases, who have undergone surgery and diagnosed between 2000 and 2017, were identified in the Netherlands Cancer Registry (NCR) database. Variables with demographic, treatment, and survival data were obtained. Survival curves were estimated by Kaplan–Meier’s method, and the effect of prognostic factors on OS was assessed in a multivariable Cox regression analysis. Results. A total of 4957 patients were identified. There were slightly more males (54.7%). Median age at diagnosis was 64 years, and 53.6% of the tumors were located in the extremities. Radiotherapy (RT) was administered to 2481 (50.1%) patients, and 252 (5.1%) patients were treated with perioperative systemic chemotherapy. 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Y.</au><au>Bovée, Judith V. M. G.</au><au>Gelderblom, Hans</au><au>Haas, Rick L.</au><au>Honoki, Kanya</au><au>Kanya Honoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of Perioperative Treatment and Survival of Localized, Resected, Intermediate- or High-Grade Soft Tissue Sarcoma: A 2000–2017 Netherlands Cancer Registry Database Analysis</atitle><jtitle>Sarcoma</jtitle><date>2021</date><risdate>2021</risdate><volume>2021</volume><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>1357-714X</issn><eissn>1369-1643</eissn><abstract>Background. Standard therapy for localized soft tissue sarcoma (STS) is wide, limb-sparing resection. For intermediate- or high-grade tumors, (neo)adjuvant therapies are frequently added to the treatment plan. In this study, data from a Dutch nationwide database are used to (1) assess whether perioperative management of STS follows ESMO guidelines, (2) characterize prognostic factors for overall survival (OS), and (3) assess the association between perioperative treatment and survival. Methods. All intermediate- or high-grade, localized STS cases, who have undergone surgery and diagnosed between 2000 and 2017, were identified in the Netherlands Cancer Registry (NCR) database. Variables with demographic, treatment, and survival data were obtained. Survival curves were estimated by Kaplan–Meier’s method, and the effect of prognostic factors on OS was assessed in a multivariable Cox regression analysis. Results. A total of 4957 patients were identified. There were slightly more males (54.7%). Median age at diagnosis was 64 years, and 53.6% of the tumors were located in the extremities. Radiotherapy (RT) was administered to 2481 (50.1%) patients, and 252 (5.1%) patients were treated with perioperative systemic chemotherapy. The total use of perioperative RT did not significantly change in the last 20 years, but the timing followed clinical guidelines: preoperative RT increased significantly (2000–2008: 3.7%, 2009–2017: 22.3%; p&lt;0.001), whereas the use of postoperative RT diminished (2000–2008: 45.9%, 2009–2017: 26.1%; p&lt;0.001). The use of perioperative chemotherapy slightly decreased (2000–2008: 5.9%, 2009–2017: 4.4%; p = 0.015). 5-year OS was 59.6% (95% CI: 58.2–61.0). Sex, age, year of diagnosis, tumor location, tumor size, histological grade, depth, histological subtype, surgical margins, and the use of perioperative RT were identified as independent predictors for OS. Conclusion. Preoperative RT is gradually replacing postoperative RT for localized STS in the Netherlands. 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subjects Adjuvant treatment
Age
Analysis
Cancer
Cancer therapies
Chemotherapy
Diagnosis
Liposarcoma
Medical prognosis
Patients
Prognosis
Radiation therapy
Sarcoma
Soft tissue sarcoma
Surgery
Survival
Tumors
Variables
title Patterns of Perioperative Treatment and Survival of Localized, Resected, Intermediate- or High-Grade Soft Tissue Sarcoma: A 2000–2017 Netherlands Cancer Registry Database Analysis
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