Soft tissue sarcomas---rare tumours of the connective tissue---should be treated at the few centres which see most cases, in order to give patients the best chance of good outcomes, concludes an analysis of sarcoma management in Florida, published in the Annals of Surgery last month.

STS [soft tissue sarcomas] are rare. This paucity leaves most health care institutions with low case volumes and outdated or inadequate resources, which impede the ability to offer optimal treatment of these rare and often complicated tumours, the authors explain.

Using an analysis of a large population-based state cancer registry in Florida, the Juan Gutierrez and colleagues tested the hypothesis that soft tissue sarcomas are better treated at institutions with higher volumes of cases. They used the Florida cancer data system, a prospective database of all cancer cases in the state of Florida since 1981, to identify all records of soft tissue sarcomas up to 2001. A total of 6259 cases were extracted and, after duplicates were removed, the researchers arrived at a total of 5564 unique cases. A final study sample of 4205 cases was created by excluding individuals who had non-surgical treatments.

Next, the researchers looked at the medical facilities where each persons treatment was done. A total of 256 institutions in Florida performed at least one resection of a soft tissue sarcoma between 1981 and 2001; these were grouped into percentile ranges by surgical procedure volume. Of 4673 surgical procedures recorded (including repeat procedures, which were excluded from the main analysis), 7 institutions performed 1504 cases (32.2%) and were classified as high volume centres. The remaining two thirds of institutions did 3169 cases (67.8% of the total) and were classed as low volume. Our analysis of 20 years surgical management of STS in Florida[showed that] volumes in 213 facilities amounted to less than 1 case per year and less than 2 cases per year were m
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European School of Oncology
9-Jul-2007