Improved nationwide survival of sarcoma patients with a network of reference centers
- Creators
- Blay, J.Y.
- Penel, N.
- Valentin, T.
- Anract, P.
- Duffaud, F.
- Dufresne, A.
- Verret, B.
- Cordoba, A.
- Italiano, A.
- Brahmi, M.
- Henon, C.
- Amouyel, T.
- Ray-Coquard, I.
- Ferron, G.
- Boudou-Rouquette, P.
- Tlemsani, C.
- Salas, S.
- Rochwerger, R.
- Faron, M.
- Bompas, E.
- Ducassou, A.
- Gangloff, D.
- Gouin, F.
- Firmin, N.
- Piperno-Neumann, S.
- Rios, M.
- Ropars, M.
- Kurtz, J.E.
- Le Nail, L.R.
- Bertucci, F.
- Carrere, S.
- Llacer, C.
- Watson, S.
- Bonvalot, S.
- Leroux, A.
- Perrin, C.
- Gantzer, J.
- Pracht, M.
- Narciso, B.
- Monneur, A.
- Lebbe, C.
- Hervieu, A.
- Saada-Bouzid, E.
- Dubray-Longeras, P.
- Fiorenza, F.
- Chaigneau, L.
- Nevieres, Z.-M.
- Soibinet, P.
- Bouché, O.
- Guillemet, C.
- Spano, J.P.
- Ruzic, J.C.
- Isambert, N.
- Vaz, G.
- Meeus, P.
- Karanian, M.
- Ngo, C.
- Coindre, J.M.
- de Pinieux, G.
- Le Loarer, F.
- Ducimetiere, F.
- Chemin, C.
- Morelle, M.
- Toulmonde, M.
- Le Cesne, A.
- Others:
- Centre Léon Bérard [Lyon]
- Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon
- Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille) ; Université de Lille-UNICANCER
- Institut Claudius Regaud
- Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037) ; Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Hôpital de la Timone [CHU - APHM] (TIMONE)
- Département de médecine oncologique [Gustave Roussy] ; Institut Gustave Roussy (IGR)
- Institut Bergonié [Bordeaux] ; UNICANCER
- Oncostat (U1018 (Équipe 2)) ; Institut Gustave Roussy (IGR)-Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay
- Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO) ; UNICANCER
- Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes)
- Unité de biologie Moléculaire, Cellulaire et du Développement (MCD) ; Centre de Biologie Intégrative (CBI) ; Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3) ; Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)
- Institut régional de Cancérologie de Montpellier (ICM)
- Institut Curie [Paris]
- Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM) ; CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
- Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL) ; UNICANCER
- Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
- Institut de Cancérologie de Strasbourg Europe (ICANS)
- CHU Trousseau [Tours] ; Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
- Institut Paoli-Calmettes (IPC) ; Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
- CRLCC Eugène Marquis (CRLCC) ; UNICANCER
- Service d'oncologie médicale [ICL Alexis Vautrin] ; Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL) ; UNICANCER-UNICANCER
- Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
- Hopital Saint-Louis [AP-HP] (AP-HP) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Département d'oncologie médicale [Centre Georges-François Leclerc] ; Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL) ; UNICANCER-UNICANCER
- Department of Oncology, Antoine Lacassagne Comprehensive Cancer Center ; Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL) ; UNICANCER-Université Côte d'Azur (UniCA)-UNICANCER-Université Côte d'Azur (UniCA)
- Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP) ; UNICANCER
- CHU Limoges
- Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
- Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC) ; Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
- Hôpital universitaire Robert Debré [Reims] (CHU Reims)
- Institut Jean Godinot [Reims] ; UNICANCER
- CHU Pitié-Salpêtrière [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Centre Hospitalier Universitaire de La Réunion (CHU La Réunion)
- Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers [La Milétrie])
- ANR-10-LABX-0061,DEVWECAN,Development Cancer and Targeted Therapies(2010)
Description
Background: We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010.Patients and methods: NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non-exhaustive), 2013-2015, and 2016-2020.Results: A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC+ database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22 435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients >18 years of age, and for both metastatic and non-metastatic patients in univariate and multivariate analyses (P < 0.0001). Over the three periods, we observed a significantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before first surgery increased from 31.7% to 44.4% (P < 0.0001). The proportion of patients with R0 resection on first surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers.Conclusions: The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.
Abstract
International audience
Additional details
- URL
- https://inserm.hal.science/inserm-04658953
- URN
- urn:oai:HAL:inserm-04658953v1
- Origin repository
- UNICA