Compliance with National Comprehensive Cancer Network guidelines in the use of radiation therapy for extremity and superficial trunk soft tissue sarcoma in the United States

2014 ◽  
Vol 109 (7) ◽  
pp. 633-638 ◽  
Author(s):  
Sanjay P. Bagaria ◽  
Jonathan B. Ashman ◽  
Larry C. Daugherty ◽  
Richard J. Gray ◽  
Nabil Wasif
Keyword(s):  
United States ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
National Comprehensive Cancer Network ◽  
The United States ◽  
Cancer Network

Compliance with NCCN guidelines in the management of extra-abdominal soft tissue sarcoma across the United States.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 178-178
Author(s):  
Nabil Wasif ◽  
Sanjay Prakash Bagaria ◽  
Jonathan Ben Ashman ◽  
Chritsopher P. Beauchamp ◽  
Richard J. Gray
Keyword(s):  
United States ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
The United States ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Radical Excision ◽  
Significant Heterogeneity

178 Background: Soft tissue sarcoma is a rare disease requiring multidisciplinary care for effective treatment. The National Comprehensive Cancer Network has developed guidelines for surgical resection and adjuvant therapy based on best available evidence. We sought to examine variance from these guidelines in treatment across the United States. Methods: The Surveillance, Epidemiology and End Results cancer registry was queried to identify patients undergoing surgery for extra-abdominal soft tissue sarcoma from 2004-2009. Coded variables signifying radical excision (RE) and the use of radiation therapy (RT) were correlated with stage of the primary tumor. Patients with metastatic disease, unknown size and unknown grade were excluded. Results: A total of 5,600 patients were identified with a median age of 61. Median tumor size was 8cm and most tumors were high grade (57% G3). Stage specific breakdown was as follows; Stage I 24%, Stage II 37% and Stage III 39%. Overall, 54% of patients underwent RE and 50% received RT, mostly in the post-operative setting (83%). The amputation rate was 4%. Although routine radiation therapy is not recommended for Stage IA and IB patients, 24% still underwent RT, whereas only 49% of Stage I patients were noted to have undergone a RE. Even though routine RT is recommended for Stage II and III tumors, 42% of patients did not undergo any RT, and only 58% underwent RE. On multivariate analysis predictors of RE were age <50 (OR 1.3, 95% CI 1.1-1.6), lower extremity tumor (OR 2.2, 95% CI 1.6- 2.8), Stage III, (OR 2.1, 95% CI 1.7- 2.6), and white race (OR 1.4, 95% CI 1.2- 1.8). Variance from guidelines was seen in 64% of patients. Conclusions: Significant heterogeneity and variation in the contemporary treatment for soft tissue sarcoma in the United States exists. Although low rates of RE may be related to coding discrepancies, rates as low as 54% are still a cause for concern. Overuse, and more importantly, underuse of RT is seen for a significant proportion of patients. If these trends are confirmed by further study, more effort will have to be directed towards compliance with appropriate treatment recommendations, perhaps by regionalizing sarcoma care.

scholarly journals Soft Tissue Sarcoma Guidelines

2007 ◽  
Vol 5 (4) ◽  
pp. 364 ◽  
Author(s):  
_ _
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Mortality Rate ◽  
Soft Tissue Sarcoma ◽  
Single Agent ◽  
Soft Tissue Sarcomas ◽  
The United States ◽  
Desmoid Tumors ◽  
Recent Version ◽  
Overall Mortality

Soft tissue sarcomas are the most frequent sarcomas; the annual incidence for 2007 in the United States is estimated at about 9220 cases, with an overall mortality rate of approximately 3560 cases per year. Important updates for the 2007 version of the guidelines include the addition of epirubicin (single agent) and the combination of epirubicin, ifosfamide, and mesna as generally accepted systemic therapy. Imatinib was added as an option for desmoid tumors. For the most recent version of the guidelines, please visit NCCN.org

Olaratumab for the treatment of patients (pts) with advanced/metastatic soft tissue sarcoma (STS): Treatment patterns in the United States (US) during the first year post-approval.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e23535-e23535
Author(s):  
Victor Manuel Villalobos ◽  
Lisa M. Hess ◽  
Yajun Zhu ◽  
Tomoko Sugihara ◽  
Pablo Lee ◽  
...  
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
The United States ◽  
Treatment Patterns ◽  
First Year ◽  
Metastatic Soft Tissue Sarcoma

scholarly journals Cost-Effectiveness of Olaratumab in Combination with Doxorubicin for Patients with Soft Tissue Sarcoma in the United States

Sarcoma ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Santiago Zuluaga-Sanchez ◽  
Lisa M. Hess ◽  
Sorrel E. Wolowacz ◽  
Yulia D’yachkova ◽  
Emma Hawe ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Meta Analysis ◽  
Single Agent ◽  
Cost Effective ◽  
Standard Of Care ◽  
The United States ◽  
Life Years

Background. Standard first-line treatments for advanced soft tissue sarcoma (STS) have changed little for 40 years, and outcomes have been poor. Recently, the United States (US) Food and Drug Administration conditionally approved olaratumab in combination with doxorubicin (Olara + Dox) based on a randomized phase II trial that reported a significant 11.8-month improvement in median survival versus single-agent doxorubicin (Dox). The present study investigated the cost-effectiveness of Olara + Dox compared with Dox and five other standard-of-care regimens from the US payer perspective. Methods. An economic model was constructed to estimate costs and outcomes over patients’ lifetimes from start of therapy. Progression-free and overall survival were based on survival analysis of patient-level data and a meta-analysis. Adverse-event rates were based on trials. Costs were from published sources. Results. Olara + Dox resulted in an estimated additional 1.27 life-years (LYs) compared with Dox, with an increase in total expected lifetime costs of $133,653. The incremental cost-effectiveness ratio (ICER) was estimated at $105,408 per LY gained; in a fully incremental analysis, all other regimens were dominated (higher costs and lower LYs or a higher ICER). Conclusion. Olara + Dox is cost-effective for STS treatment compared with Dox and other standard-of-care regimens at willingness-to-pay thresholds of $150,000 per LY and above.

Evaluating efficacy of current lung cancer screening guidelines

2017 ◽  
Vol 24 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Barbara Nemesure ◽  
April Plank ◽  
Lisa Reagan ◽  
Denise Albano ◽  
Michael Reiter ◽  
...  
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cancer Screening ◽  
National Comprehensive Cancer Network ◽  
Task Force ◽  
Preventive Services ◽  
Lung Cancer Screening ◽  
The United States ◽  
Smoking History ◽  
Cancer Network

Objective Current lung cancer screening criteria based primarily on outcomes from the National Lung Screening Trial may not adequately capture all subgroups of the population at risk. We aimed to evaluate the efficacy of lung cancer screening criteria recommended by the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and the National Comprehensive Cancer Network in identifying known cases of lung cancer. Methods An investigation of the Stony Brook Cancer Center Lung Cancer Evaluation Center's database identified 1207 eligible, biopsy-proven lung cancer cases diagnosed between January 1996 and March 2016. Age at diagnosis, smoking history, and other known risk factors for lung cancer were used to determine the proportion of cases that would have met current United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and National Comprehensive Cancer Network eligibility requirements for lung cancer screening. Results Of the 1046 ever smokers in the study, 40% did not meet the National Lung Screening Trial age requirements, 20% did not have a ≥30 pack year smoking history, and approximately one-third quit smoking >15 years before diagnosis, thus deeming them ineligible for screening. Applying the United States Preventive Services Task Force, Centers for Medicare and Medicaid Services, and National Comprehensive Cancer Network eligibility criteria to the Stony Brook Cancer Center's Lung Cancer Evaluation Center cases, 49.2, 46.3, and 69.8%, respectively, would have met the current lung cancer screening guidelines. Conclusions The United States Preventive Services Task Force and Centers for Medicare and Medicaid Services eligibility criteria for lung cancer screening captured less than 50% of lung cancer cases in this investigation. These findings highlight the need to reevaluate the efficacy of current guidelines and may have major public health implications.

A novel preoperative risk score to guide patient selection for resection of soft tissue sarcoma lung metastases: An analysis from the United States Sarcoma Collaborative

2021 ◽  
Author(s):  
Rachel M. Lee ◽  
Cecilia G. Ethun ◽  
Adriana C. Gamboa ◽  
Michael K. Turgeon ◽  
Thuy Tran ◽  
...  
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Risk Score ◽  
Patient Selection ◽  
Lung Metastases ◽  
The United States ◽  
Preoperative Risk ◽  
Selection For

scholarly journals Literacy analysis of National Comprehensive Cancer Network patient guidelines for the most common malignancies in the United States

Cancer ◽  
2017 ◽  
Vol 124 (4) ◽  
pp. 769-774 ◽  
Author(s):  
Bao Ngoc N. Tran ◽  
Qing Z. Ruan ◽  
Sherise Epstein ◽  
Joseph A. Ricci ◽  
Rima E. Rudd ◽  
...  
Keyword(s):  
United States ◽  
National Comprehensive Cancer Network ◽  
The United States ◽  
Patient Guidelines ◽  
Cancer Network

scholarly journals An evaluation of reports of dioxin exposure and soft tissue sarcoma pathology among chemical workers in the United States.

1984 ◽  
Vol 10 (5) ◽  
pp. 299-303 ◽  
Author(s):  
M A Fingerhut ◽  
W E Halperin ◽  
P A Honchar ◽  
A B Smith ◽  
D H Groth ◽  
...  
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
The United States ◽  
Chemical Workers ◽  
Dioxin Exposure
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