National Comprehensive Cancer Network guidelines compliance of a sarcoma service: A retrospective review

Abstract

BACKGROUND Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network (NCCN) to ensure patients are treated uniformly and appropriately. This study sought to retrospectively review patients with a new diagnosis of sarcoma who were treated in a National Cancer Institute (NCI) designated center and determine compliance rates with guidelines for sarcoma. AIM To evaluate our compliance of NCCN sarcoma guidelines at a major NCI designated center and to report instances of deviation that could be used for future studies to improve patient care. METHODS Data was collected retrospectively as an internal review and quality assessment of 35 newly diagnosed and treated patients. Demographic data were recorded and information concerning whether patients had appropriate imaging, biopsy and management. Variables of interest were expressed as raw numbers and percentages. RESULTS Primary site imaging was obtained in 100% of cases. Chest and full-body imaging were obtained in 97% and 100% of indicated cases, respectively. Tissue was obtained preoperatively in 97% of cases. Imaging was reviewed at multidisciplinary Treatment Planning Conference (TPC) in 97% of cases. Pathology was reviewed in 94% of cases in TPC. Both tumor, node, metastasis staging and plan of care were reviewed in 100% of cases in TPC. Treatment guidelines were followed in 94% of cases reviewed. CONCLUSION This study evaluated the workup and treatment provided by a single NCI designated sarcoma service to a series of patients with pathologies defined with the NCCN sarcoma treatment guidelines. Although adherence to NCCN was reported to be very high future prospective studies are required to investigate whether NCCN guidelines impact patient outcomes.

Centralized and Interdisciplinary Therapy Management in the Treatment of Sarcomas

“…A retrospective study by Blank et al carried out at a US cancer centre monitored the performance of national guidelines and showed that in 97% and 94% of cases, the imaging and pathological diagnosis were revised by the multidisciplinary tumour board, respectively. In addition, a treatment plan was discussed for each patient in an interdisciplinary tumour board [33]. Hollunder et al described that 59.1% of the recommendations of the multidisciplinary tumour board were carried out entirely and 14.4% partially in a retrospective analysis of sarcomas and musculoskeletal tumours at a German Cancer Centre.…”

Integrated Analysis of the Transcriptome Profile Reveals the Potential Roles Played by Long Noncoding RNAs in Immunotherapy for Sarcoma

“…Multidisciplinary management is best for sarcoma therapy (7)(8)(9)(10)(11)(12). Surgical resection with or without radiotherapy and chemotherapy is the standard therapy for localized sarcoma (10,13).…”

“…Surgical resection with or without radiotherapy and chemotherapy is the standard therapy for localized sarcoma (10,13). Systemic therapy has a prominent role in the multidisciplinary management of locally inoperable or metastatic sarcomas (7,14). Cytotoxic chemotherapy has been the mainstay therapy for treating advanced-stage disease, with overall response rates of approximately 25% in the first-line setting.…”