Adherence to treatment guidelines for primary sarcomas affects patient survival: A side study of the european CONnective TIssue CAncer NETwork (CONTICANET)

C. R. Rossi, A. Vecchiato, G. Mastrangelo, M. C. Montesco, F. Russano, S. Mocellin, S. Pasquali, G. Scarzello, U. Basso, A. Frasson, P. Pilati, D. Nitti, A. Lurkin, I. Ray-Coquard

Research output: Contribution to journalArticle

Abstract

Background: The impact of adherence to clinical practice guidelines (CPGs) for loco-regional treatment (i.e. surgery and radiotherapy) and chemotherapy on local disease control and survival in sarcoma patients was investigated in a European study conducted in an Italian region (Veneto).Patients and methods: The completeness of the adherence to the Italian CPGs for sarcomas treatment was assessed by comparing the patient's charts and the CPGs. Propensity score-adjusted multivariate survival analysis was used to assess the impact of CPGs adherence on patient clinical outcomes. Results: A total of 151 patients were included. Adherence to CPGs for loco-regional therapy and chemotherapy was observed in 106 out of 147 (70.2%) and 129 out of 139 (85.4%) patients, respectively. Non-adherence to CPGs for loco-regional treatment was independently associated with AJCC stage III disease [odds ratio (OR) 1.77, P = 0.011] and tumor-positive excision margin (OR 3.55, P = 0.003). Patients not treated according to the CPGs were at a higher risk of local recurrence [hazard ratio (HR) 5.4, P <0.001] and had a shorter sarcoma-specific survival (HR 4.05, P <0.001), independently of tumor stage. Conclusions: Incomplete adherence to CPGs for loco-regional treatment of sarcomas was associated with worse prognosis in patients with non-metastatic tumors.

Original languageEnglish
Pages (from-to)1685-1691
Number of pages7
JournalAnnals of Oncology
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 2013

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Keywords

  • Clinical practice guidelines
  • Prognosis
  • Sarcomas

ASJC Scopus subject areas

  • Oncology
  • Hematology

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