According to an article recently published in Annals of Surgery, survival and physical function for patients with soft tissue sarcoma (STS) are significantly improved for those treated at a medical center that treats high volumes of patients with this disease when compared with medical centers that treat lower volumes.
Soft tissue sarcoma refers to a group of cancers that may originate from several types of soft tissues in the body such as fat, muscle, and ligaments. Depending on the type of STS present, STS may be found at several different anatomical locations in the body. Patients with STS of the limbs must often undergo surgical removal of at least the partial limb; however physicians try to limit the degree of amputation through pre-operative therapy.
Results from several recent clinical studies have indicated that patients with various types of cancers may experience improved survival when treated at hospitals that treat a high volume of patients with their specific disease or when they are treated by physicians who specialize in their disease.
Researchers from Florida recently conducted a clinical study to further evaluate the link between hospital and physician volume and outcomes for STS. This study included 4,205 patients registered in the Florida Cancer Data System (FCDS) who were treated between 1981 and 2001. High-volume medical centers were defined as “facilities above the 67th percentile for volume” in comparison with other centers with regards to treatment for patients with STS.
• A higher proportion of aggressive-type cancers and large cancers were surgically removed at high-volume centers.
• Among patients with aggressive-type cancers, median survival was 30 months for patients treated at high-volume centers compared with 24 months for those treated at lower-volume centers.
• Among patients with larger cancers (over 10 cm), median survival was 28 months for those treated at high-volume centers compared with 19 months for those treated at lower-volume centers.
• Patients with STS on their trunk or sides of lower back had an eight-month median improved survival when treated at a high-volume center.
• Amputation of a limb occurred at a significantly lower rate at a high-volume center than a lower-volume center (9.4% versus 13.8%, respectively).
The researchers concluded that patients with STS have significantly improved survival and functional outcomes when treated at a high-volume center, particularly patients with large or aggressive cancers or those with cancers located on the trunk of the body. Patients with STS may wish to consider treatment at a high-volume medical center.
Reference: Gutierrez J, Perez E, Moffat F, et al. Should soft tissue sarcomas be treated at high-volume centers?: An Analysis of 4205 Patients. Annals of Surgery. 2007;245:952-958.