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Comparative Effectiveness Research for Sarcoma

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Comparative Effectiveness in Surgical Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 164))

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Abstract

Modern multidisciplinary management of sarcoma represents several opportunities for comparative effectiveness research. Focusing on the outcomes of survival, quality of life and cost-effectiveness of care, the current state of the art is summarized. Specialized/regional care for sarcoma and the utility of tumor boards or multispecialty discussion is discussed. Issues related to treatment efficacy and sequencing in relation to chemotherapy, radiation, and surgery as well as margin reporting and surveillance are also discussed. Finally, future avenues of comparative effectiveness research for sarcoma are highlighted throughout the chapter.

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References

  1. NCCN clinical practice guidelines in oncology (NCCN)—soft tissue sarcoma 2013. Available at www.nccn.org

  2. Wasif N, Tamurian RM, Christensen S et al (2012) Influence of specialty and clinical experience on treatment sequencing in the multimodal management of soft tissue extremity sarcoma. Ann Surg Oncol 19(2):504–510

    Article  PubMed  Google Scholar 

  3. Wasif N, Smith CA, Tamurian RM et al (2013) Influence of physician specialty on treatment recommendations in the multidisciplinary management of soft tissue sarcoma of the extremities. JAMA Surg 148(7):632–639

    Article  PubMed  Google Scholar 

  4. Ray-Coquard I, Thiesse P, Ranchere-Vince D et al (2004) Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas. Ann Oncol Official J Eur Soc Med Oncol/ESMO 15(2):307–315

    Article  CAS  Google Scholar 

  5. Jansen-Landheer ML, Krijnen P, Oostindier MJ et al (2009) Improved diagnosis and treatment of soft tissue sarcoma patients after implementation of national guidelines: a population-based study. Eur J Surg Oncol J Eur Soc Surg Oncol Brit Assoc Surg Oncol 35(12):1326–1332

    CAS  Google Scholar 

  6. Bagaria SP, Ashman JB, Daugherty LC et al (2014) Compliance with national comprehensive cancer network guidelines in the use of radiation therapy for extremity and superficial trunk soft tissue sarcoma in the United States. J Surg Oncol 109(7):633–638

    Article  PubMed  Google Scholar 

  7. Perrier L, Buja A, Mastrangelo G et al (2012) Clinicians’ adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions. BMC Health Serv Res 12:82

    Article  PubMed Central  PubMed  Google Scholar 

  8. Gutierrez JC, Perez EA, Moffat FL et al (2007) Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients. Ann Surg 245(6):952–958

    Article  PubMed Central  PubMed  Google Scholar 

  9. Clasby R, Tilling K, Smith MA et al (1997) Variable management of soft tissue sarcoma: regional audit with implications for specialist care. Br J Surg 84(12):1692–1696

    Article  CAS  PubMed  Google Scholar 

  10. Nijhuis PH, Schaapveld M, Otter R et al (2001) Soft tissue sarcoma–compliance with guidelines. Cancer 91(11):2186–2195

    Article  CAS  PubMed  Google Scholar 

  11. Meric F, Milas M, Hunt KK et al (2000) Impact of neoadjuvant chemotherapy on postoperative morbidity in soft tissue sarcomas. J Clin Oncol Official J Am Soc Clin Oncol 18(19):3378–3383

    CAS  Google Scholar 

  12. Gortzak E, Azzarelli A, Buesa J et al (2001) A randomised phase II study on neo-adjuvant chemotherapy for ‘high-risk’ adult soft-tissue sarcoma. Eur J Cancer 37(9):1096–1103

    Article  CAS  PubMed  Google Scholar 

  13. Issels RD, Lindner LH, Verweij J et al (2010) Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol 11(6):561–570

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Kraybill WG, Harris J, Spiro IJ et al (2006) Phase II study of neoadjuvant chemotherapy and radiation therapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: radiation therapy oncology group trial 9514. J Clin Oncol Official J Am Soc Clin Oncol 24(4):619–625

    Article  CAS  Google Scholar 

  15. Adjuvant chemotherapy for localised resectable soft-tissue sarcoma of adults: meta-analysis of individual data. Sarcoma Meta-analysis Collaboration. Lancet 1997 350(9092):1647–1654

    Google Scholar 

  16. Pervaiz N, Colterjohn N, Farrokhyar F et al (2008) A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer 113(3):573–581

    Article  PubMed  Google Scholar 

  17. Rosenberg SA, Tepper J, Glatstein E et al (1982) The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 196(3):305–315

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Yang JC, Chang AE, Baker AR et al (1998) Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol Official J Am Soc Clin Oncol 16(1):197–203

    CAS  Google Scholar 

  19. Pisters PW, Pollock RE, Lewis VO et al (2007) Long-term results of prospective trial of surgery alone with selective use of radiation for patients with T1 extremity and trunk soft tissue sarcomas. Ann Surg 246(4):675–681 discussion 681–682

    Article  PubMed  Google Scholar 

  20. O’Sullivan B, Davis AM, Turcotte R et al (2002) Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 359(9325):2235–2241

    Article  PubMed  Google Scholar 

  21. Davis AM, O’Sullivan B, Turcotte R et al (2005) Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother Oncol J Eur Soc Ther Radiol Oncol 75(1):48–53

    Article  Google Scholar 

  22. Sherman KL, Wayne JD, Chung J et al (2013) Assessment of multimodality therapy use for extremity sarcoma in the United States. J Surg Oncol 109(5):395–404

    Article  PubMed  Google Scholar 

  23. Pisters PW, Harrison LB, Woodruff JM et al (1994) A prospective randomized trial of adjuvant brachytherapy in the management of low-grade soft tissue sarcomas of the extremity and superficial trunk. J Clin Oncol Official J Am Soc Clin Oncol 12(6):1150–1155

    CAS  Google Scholar 

  24. Pisters PW, Harrison LB, Leung DH et al (1996) Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol Official J Am Soc Clin Oncol 14(3):859–868

    CAS  Google Scholar 

  25. Lewis JJ, Leung D, Heslin M et al (1997) Association of local recurrence with subsequent survival in extremity soft tissue sarcoma. J Clin Oncol Official J Am Soc Clin Oncol 15(2):646–652

    CAS  Google Scholar 

  26. Ramanathan RC, A’Hern R, Fisher C et al (2001) Prognostic index for extremity soft tissue sarcomas with isolated local recurrence. Ann Surg Oncol 8(4):278–289

    Article  CAS  PubMed  Google Scholar 

  27. Hueman MT, Herman JM, Ahuja N (2008) Management of retroperitoneal sarcomas. Surg Clin N Am 88(3):583–597 vii

    Article  PubMed  Google Scholar 

  28. Schwartz HS, Spengler DM (1997) Needle tract recurrences after closed biopsy for sarcoma: three cases and review of the literature. Ann Surg Oncol 4(3):228–236

    Article  CAS  PubMed  Google Scholar 

  29. Hoeber I, Spillane AJ, Fisher C et al (2001) Accuracy of biopsy techniques for limb and limb girdle soft tissue tumors. Ann Surg Oncol 8(1):80–87

    Article  CAS  PubMed  Google Scholar 

  30. Bonvalot S, Miceli R, Berselli M et al (2010) Aggressive surgery in retroperitoneal soft tissue sarcoma carried out at high-volume centers is safe and is associated with improved local control. Ann Surg Oncol 17(6):1507–1514

    Article  PubMed  Google Scholar 

  31. Tseng WH, Martinez SR, Tamurian RM et al (2011) Contiguous organ resection is safe in patients with retroperitoneal sarcoma: an ACS-NSQIP analysis. J Surg Oncol 103(5):390–394

    Article  PubMed  Google Scholar 

  32. Bonvalot S, Rivoire M, Castaing M et al (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol Official J Am Soc Clin Oncol 27(1):31–37

    Article  Google Scholar 

  33. Mullinax JE, Zager JS, Gonzalez RJ (2011) Current diagnosis and management of retroperitoneal sarcoma. Cancer Control J Moffitt Cancer Cent 18(3):177–187

    Google Scholar 

  34. Kane JM 3rd (2006) At the crossroads for retroperitoneal sarcomas: the future of clinical trials for this “orphan disease”. Ann Surg Oncol 13(4):442–443

    Article  PubMed  Google Scholar 

  35. Kaushal A, Citrin D (2008) The role of radiation therapy in the management of sarcomas. Surg Clin N Am 88(3):629–646 viii

    Article  PubMed Central  PubMed  Google Scholar 

  36. Pawlik TM, Pisters PW, Mikula L et al (2006) Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma. Ann Surg Oncol 13(4):508–517

    Article  PubMed  Google Scholar 

  37. Ballo MT, Zagars GK, Pollock RE et al (2007) Retroperitoneal soft tissue sarcoma: an analysis of radiation and surgical treatment. Int J Radiat Oncol Biol Phys 67(1):158–163

    Article  PubMed  Google Scholar 

  38. Bossi A, De Wever I, Van Limbergen E et al (2007) Intensity modulated radiation-therapy for preoperative posterior abdominal wall irradiation of retroperitoneal liposarcomas. Int J Radiat Oncol Biol Phys 67(1):164–170

    Article  PubMed  Google Scholar 

  39. Gieschen HL, Spiro IJ, Suit HD et al (2001) Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 50(1):127–131

    Article  CAS  PubMed  Google Scholar 

  40. Bobin JY, Al-Lawati T, Granero LE et al (2003) Surgical management of retroperitoneal sarcomas associated with external and intraoperative electron beam radiotherapy. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 29(8):676–681

    CAS  Google Scholar 

  41. Dziewirski W, Rutkowski P, Nowecki ZI et al (2006) Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas. Ann Surg Oncol 13(2):245–252

    Article  PubMed  Google Scholar 

  42. Trovik CS, Skjeldal S, Bauer H et al (2012) Reliability of margin assessment after surgery for extremity soft tissue sarcoma: the SSG experience. Sarcoma 2012:290698

    Article  PubMed Central  PubMed  Google Scholar 

  43. Whooley BP, Gibbs JF, Mooney MM et al (2000) Primary extremity sarcoma: what is the appropriate follow-up? Ann Surg Oncol 7(1):9–14

    Article  CAS  PubMed  Google Scholar 

  44. Kane JM 3rd (2004) Surveillance strategies for patients following surgical resection of soft tissue sarcomas. Curr Opin Oncol 16(4):328–332

    Article  PubMed  Google Scholar 

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Correspondence to Nabil Wasif .

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Wasif, N. (2015). Comparative Effectiveness Research for Sarcoma. In: Bilimoria, K., Minami, C., Mahvi, D. (eds) Comparative Effectiveness in Surgical Oncology. Cancer Treatment and Research, vol 164. Springer, Cham. https://doi.org/10.1007/978-3-319-12553-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-12553-4_4

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