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dc.contributor.authorHoekstra, HJ
dc.contributor.authorHaas, RLM
dc.contributor.authorVerhoef, C
dc.contributor.authorSuurmeijer, AJH
dc.contributor.authorvan Rijswijk, CSP
dc.contributor.authorBongers, BGH
dc.contributor.authorvan der Graaf, WT
dc.contributor.authorHo, VKY
dc.date.accessioned2018-02-19T12:42:50Z
dc.date.issued2017-10
dc.identifier.citationAnnals of surgical oncology, 2017, 24 (11), pp. 3279 - 3288
dc.identifier.issn1068-9265
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1295
dc.identifier.eissn1534-4681
dc.identifier.doi10.1245/s10434-017-6003-3
dc.description.abstractIntroduction Optimal management of soft tissue sarcoma (STS) remains a challenge. A nationwide survey assessed the quality of STS care in the Netherlands, thereby aiming to identify potentialities for improvement through more centralized disease management.Methods From the Netherlands Cancer Registry (NCR), data were obtained on 3317 adult STS patients (excluding gastrointestinal stromal tumor, GIST) diagnosed in 2006-2011. Logistic regression models were employed to compare outcomes on selected clinical indicators reflecting prevailing STS guidelines between high-volume (≥10 resections annually) and low-volume (<10 resections) hospitals, between academic and general hospitals, and between sarcoma research centers and other hospitals, adjusted for case mix. Analyses were performed on imputed datasets (m = 50), generated through multiple imputations by chained equations.Results Overall, 89% of patients underwent surgical resection. Resection status remained unknown in 24% (excluding those with metastasized disease), and grade was not documented for one-third of tumors. Microscopic residual disease was detected in 20% with an increased risk for older patients, larger and deeply located tumors, and those located in the (retro)peritoneum or upper extremity. Almost half of patients with an R1 resection received adjuvant radiotherapy. Following adjustment for case mix factors, patients treated in high-volume hospitals less often had macroscopic residual disease (R2 resection; adjusted odds ratio: 0.54). A strongly skewed distribution of surgical volumes was observed.Conclusions These survey results indicate a potential for improving Dutch STS care. More centralized sarcoma management should improve definitive pathology reporting on tumor characteristics, adherence to treatment guidelines and overall disease outcome.
dc.formatPrint-Electronic
dc.format.extent3279 - 3288
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectSarcoma
dc.subjectPrognosis
dc.subjectRegistries
dc.subjectFollow-Up Studies
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectGuideline Adherence
dc.subjectNetherlands
dc.subjectFemale
dc.subjectMale
dc.subjectPractice Guidelines as Topic
dc.subjectSurveys and Questionnaires
dc.titleAdherence to Guidelines for Adult (Non-GIST) Soft Tissue Sarcoma in the Netherlands: A Plea for Dedicated Sarcoma Centers.
dc.typeJournal Article
dcterms.dateAccepted2017-07-17
rioxxterms.versionofrecord10.1245/s10434-017-6003-3
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2017-10
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfAnnals of surgical oncology
pubs.issue11
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume24
pubs.embargo.termsNot known
dc.contributor.icrauthorMarsden,en


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