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dc.contributor.authorHoekstra, HJen_US
dc.contributor.authorHaas, RLMen_US
dc.contributor.authorVerhoef, Cen_US
dc.contributor.authorSuurmeijer, AJHen_US
dc.contributor.authorvan Rijswijk, CSPen_US
dc.contributor.authorBongers, BGHen_US
dc.contributor.authorvan der Graaf, WTen_US
dc.contributor.authorHo, VKYen_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2018-02-19T12:42:50Z
dc.date.issued2017-10en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28748443en_US
dc.identifier10.1245/s10434-017-6003-3en_US
dc.identifier.citationAnn Surg Oncol, 2017, 24 (11), pp. 3279 - 3288en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1295
dc.identifier.eissn1534-4681en_US
dc.identifier.doi10.1245/s10434-017-6003-3en_US
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.en_US
dc.format.extent3279 - 3288en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectAdulten_US
dc.subjectAgeden_US
dc.subjectAged, 80 and overen_US
dc.subjectFemaleen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectGuideline Adherenceen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectNetherlandsen_US
dc.subjectPractice Guidelines as Topicen_US
dc.subjectPrognosisen_US
dc.subjectRegistriesen_US
dc.subjectSarcomaen_US
dc.subjectSurveys and Questionnairesen_US
dc.titleAdherence to Guidelines for Adult (Non-GIST) Soft Tissue Sarcoma in the Netherlands: A Plea for Dedicated Sarcoma Centers.en_US
dc.typeJournal Article
dcterms.dateAccepted2017-07-17en_US
rioxxterms.versionofrecord10.1245/s10434-017-6003-3en_US
rioxxterms.licenseref.startdate2017-10en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfAnn Surg Oncolen_US
pubs.issue11en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume24en_US
pubs.embargo.termsNot knownen_US
dc.contributor.icrauthorMarsden,en_US


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