Impact of centralization in primary retroperitoneal sarcoma treatment: analysis using hospital-based cancer registry dat
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ORIGINAL ARTICLE
Impact of centralization in primary retroperitoneal sarcoma treatment: analysis using hospital‑based cancer registry data in Japan Tomokazu Kimura1 · Koji Kawai1 · Shuya Kandori1 · Satoshi Nitta1 · Kosuke Kojo1 · Yoshiyuki Nagumo1 · Hiromitsu Negoro1 · Ayako Okuyama2 · Takahiro Higashi2 · Takahiro Kojima1 · Hiroyuki Nishiyama1 Received: 27 February 2020 / Accepted: 12 May 2020 © Japan Society of Clinical Oncology 2020
Abstract Background To elucidate the clinicopathological features, hospital-based care volume and prognoses associated with primary retroperitoneal sarcoma (PRS). Methods Clinical data on PRS cases, diagnosed from 2008 to 2009 (cohort A) and from 2012 to 2015 (cohort B), were obtained from the national hospital-based cancer registry in Japan. Since data on survival, 5 years after PRS diagnosis, were available only for cohort A, patient prognoses were analyzed in this group alone. Results The numbers of participating hospitals were 154 in cohort A and 537 in cohort B. In total, 380 and 2011 patients with PRS were identified in cohorts A and B, respectively. The incidence of PRS among all the registered urogenital malignancies was 0.52% (2391/462,866). Liposarcoma was the most commonly observed PRS subtype (55.8%), followed by leiomyosarcoma (19.0%). In cohort A, the 5-year overall survival (OS) was 40.4%. The 5-year OS associated with stage I (n = 107), stages II and III (n = 61), and stage IV (n = 59) disease were 59%, 39%, and 6%, respectively. Only two institutions treated over ten patients per year in each cohort. When institutions were divided by hospital care volume (8 hospitals with ≥ = 3 cases and 149 with 90% follow-up (F/U) rate for all cancer patients. We could not calculate the median F/U period of these patients, because data on the exact F/U period for some of the patients were not available in this database. Trained cancer registrars at registered hospitals report data on each cancer case based on standardized rules and criteria, for submission to the HBCR. The data were entered by trained practitioners who took the tumor registrar training programs coordinated by the National Cancer Center in Japan. We extracted the cases who started their first-course
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International Journal of Clinical Oncology
treatment at the hospital to avoid duplicate counting. These include data on demographics and cancer characteristics, including topology and morphology codes of the International Classification of Diseases for Oncology, 3rd edition (ICD-O-3), and the TNM Classification as well as initial treatments. The 6th edition of the TNM Classification was used in cohort A, and the 7th edition in cohort B. The details of histology are shown in supplemental table 1.
Data extraction To realize the status of urological STS, we extracted eligible cases according to the availability of data on patient age, sex, histology of sarcoma, registered institution, site, treatment, stage, and prognosis. We performed abstraction with the following criteria: malignancies (1) that were diagnosed
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