BMC Cancer (Jan 2023)

Management and outcomes of adolescent and young adult sarcoma patients: results from the French nationwide database NETSARC

  • Pierre Kubicek,
  • Axel Le Cesne,
  • Cyril Lervat,
  • Maud Toulmonde,
  • Christine Chevreau,
  • Florence Duffaud,
  • Louis-Romée Le Nail,
  • Magali Morelle,
  • Nathalie Gaspar,
  • Cécile Vérité,
  • Marie-Pierre Castex,
  • Nicolas Penel,
  • Esma Saada,
  • Sylvain Causeret,
  • François Bertucci,
  • Christophe Perrin,
  • Emmanuelle Bompas,
  • Daniel Orbach,
  • Valérie Laurence,
  • Sophie Piperno-Neumann,
  • Philippe Anract,
  • Maria Rios,
  • Jean-Claude Gentet,
  • Éric Mascard,
  • Stéphanie Pannier,
  • Pascale Blouin,
  • Sébastien Carrère,
  • Loïc Chaigneau,
  • Pauline Soibinet-Oudot,
  • Nadège Corradini,
  • Pascaline Boudou-Rouquette,
  • Jean-Christophe Ruzic,
  • Valérie Lebrun-Ly,
  • Pascale Dubray-Longeras,
  • Sharmini Varatharajah,
  • Céleste Lebbe,
  • Mickaël Ropars,
  • Jean-Emmanuel Kurtz,
  • Cécile Guillemet,
  • Jean-Pierre Lotz,
  • Juliane Berchoud,
  • Grégory Cherrier,
  • Françoise Ducimetière,
  • Claire Chemin,
  • Antoine Italiano,
  • Charles Honoré,
  • Emmanuel Desandes,
  • Jean-Yves Blay,
  • François Gouin,
  • Perrine Marec-Bérard

DOI
https://doi.org/10.1186/s12885-023-10556-4
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 11

Abstract

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Abstract Background The initial management of patients with sarcoma is a critical issue. We used the nationwide French National Cancer Institute-funded prospective sarcoma database NETSARC to report the management and oncologic outcomes in adolescents and young adults (AYAs) patients with sarcoma at the national level. Patients and methods NETSARC database gathers regularly monitored and updated data from patients with sarcoma. NETSARC was queried for patients (15–30 years) with sarcoma diagnosed from 2010 to 2017 for whom tumor resection had been performed. We reported management, locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) in AYA treated in French reference sarcoma centers (RSC) and outside RSC (non-RSC) and conducted multivariable survival analyses adjusted for classical prognostic factors. Results Among 3,227 patients aged 15–30 years with sarcoma diagnosed between 2010 and 2017, the study included 2,227 patients with surgery data available, among whom 1,290 AYAs had been operated in RSC, and 937 AYAs in non-RSC. Significant differences in compliance to guidelines were observed including pre-treatment biopsy (RSC: 85.9%; non-RSC 48.1%), pre-treatment imaging (RSC: 86.8%; non-RSC: 56.5%) and R0 margins (RSC 57.6%; non-RSC: 20.2%) (p < 0.001). 3y-OS rates were 81.1% (95%CI 78.3–83.6) in AYA in RSC and 82.7% (95%CI 79.4–85.5) in AYA in non-RSC, respectively. Whereas no significant differences in OS was observed in AYAs treated in RSC and in non-RSC, LRFS and PFS were improved in AYAs treated in RSC compared to AYAs treated in non-RSC (Hazard Ratios (HR): 0.58 and 0.83, respectively). Conclusions This study highlights the importance for AYA patients with sarcoma to be managed in national sarcoma reference centers involving multidisciplinary medical teams with paediatric and adult oncologists.

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