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Annals of Surgical Oncology

, Volume 26, Issue 7, pp 2286–2293 | Cite as

Survival Benefit of the Surgical Management of Retroperitoneal Sarcoma in a Reference Center: A Nationwide Study of the French Sarcoma Group from the NetSarc Database

  • S. BonvalotEmail author
  • E. Gaignard
  • E. Stoeckle
  • P. Meeus
  • G. Decanter
  • S. Carrere
  • C. Honore
  • J. B. Delhorme
  • M. Fau
  • D. Tzanis
  • S. Causeret
  • P. Gimbergues
  • J. M. Guillois
  • B. Meunier
  • A. Le Cesne
  • F. Ducimetiere
  • M. Toulmonde
  • J. Y. Blay
Sarcoma

Abstract

Background

Guidelines recommend that retroperitoneal sarcoma (RPS) be managed in a reference sarcoma center (RSC), but the benefit remains to be demonstrated. This study investigated the impact of initial surgery performed within the NetSarc network on overall survival (OS).

Methods

NetSarc is a network of 26 RSCs with specialized multidisciplinary tumor boards (MDTs) that is funded by the French NCI. Since 2010, presentation to an MDT and second pathological review are mandatory for sarcoma patients, and data have been collected in a nationwide database. We extracted data for all patients who received surgery in or outside the network and who presented at a NetSarc center (NSC) for primary nonmetastatic RPS between 2010 and 2017.

Results

A total of 2945 patients were included: 1078 (36.6%) underwent the first surgery in an NSC, and 1867 (63.4%) in an out-of-network center. The median number of operations at an NSC during the study period was 23 (range: 3–209), and the corresponding median was 1 (range: 1–2) at out-of-network centers. The diagnostic procedures followed significantly more clinical practice guidelines within NetSarc, where there were significantly more first R0 resections [452 (41.9%) vs. 230 (12.3%)]. The OS was significantly superior for patients treated within NetSarc, with a 2-year OS of 87% vs. 70% (p < 0.001). In the multivariate analysis, surgery within an NSC was an independent predictor of OS, with a twofold lower odds ratio of death.

Conclusions

In this national study, surgery for primary RPS within an NSC was associated with a better OS.

Notes

Acknowledgement

Supported by NetSarc (INCA & DGOS) and RREPS (INCA & DGOS), RESOS (INCA & DGOS) and LYRICAN (INCA-DGOS-INSERM 12563), Association DAM’s, Ensemble contre Le GIST, Eurosarc (FP7-278742), la Fondation ARC, Infosarcome, InterSARC (INCA), LabEx DEvweCAN (ANR-10-LABX-0061), Ligue de L’Ain contre le Cancer, La Ligue contre le Cancer, EURACAN (EC 739521).

Disclosure

No disclosure of any commercial interest.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • S. Bonvalot
    • 1
    Email author
  • E. Gaignard
    • 1
  • E. Stoeckle
    • 2
  • P. Meeus
    • 3
  • G. Decanter
    • 4
  • S. Carrere
    • 5
  • C. Honore
    • 6
  • J. B. Delhorme
    • 7
  • M. Fau
    • 8
  • D. Tzanis
    • 1
  • S. Causeret
    • 9
  • P. Gimbergues
    • 10
  • J. M. Guillois
    • 11
  • B. Meunier
    • 12
  • A. Le Cesne
    • 13
  • F. Ducimetiere
    • 14
  • M. Toulmonde
    • 15
  • J. Y. Blay
    • 16
  1. 1.Department of Surgery, Institut CuriePSL UniversityParisFrance
  2. 2.Department of SurgeryInstitut BergoniéBordeauxFrance
  3. 3.Department of SurgeryCentre Léon BérardLyonFrance
  4. 4.Department of SurgeryCentre Oscar LambretLilleFrance
  5. 5.Department of SurgeryInstitut du Cancer Val d’AurelleMontpellierFrance
  6. 6.Department of SurgeryGustave Roussy Cancer CampusVillejuifFrance
  7. 7.Department of SurgeryCHRU de HautepierreStrasbourgFrance
  8. 8.Department of SurgeryInstitut de Cancérologie de LorraineNancyFrance
  9. 9.Department of SurgeryCentre Georges-François LeclercDijonFrance
  10. 10.Department of SurgeryCentre Jean PerrinClermont-FerrandFrance
  11. 11.Department of SurgeryCentre François BaclesseCaenFrance
  12. 12.Department of SurgeryCHU PontchaillouRennesFrance
  13. 13.Department of Medical OncologyGustave Roussy Cancer CampusVillejuifFrance
  14. 14.Equipe Evaluation Médicale et Sarcome (EMS)Centre Léon BérardLyonFrance
  15. 15.Department of Medical OncologyInstitut BergoniéBordeauxFrance
  16. 16.Department of Medical OncologyCentre Léon BérardLyonFrance

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