Soft Tissue Sarcomas Have Much Better Outcomes at High-Volume Centers By Martha Kerr An analysis of outcome and survival rates of patients with soft tissue sarcomas in Florida shows that patients treated at high-volume centers "have significantly better survival and functional outcomes" than those cared for at smaller treatment centers. Dr. Leonides Koniaris of the University of Miami and colleagues analyzed outcomes of 4,205 operative soft tissue sarcomas treated between 1981 and 2001 and registered in the Florida Cancer Data System. Results are published in the June issue of the Annals of Surgery. Overall, 68.1% were managed at low-volume treatment centers and 31.9% were cared for at high-volume centers. Patients treated at high-volume centers were more likely to have high-grade sarcomas (53.8%) than were those treated at low-volume centers (44.3%), and were more likely to have tumors greater than 10 cm (40.7% versus 28.7%). The 30-day mortality rate was 0.7% at the high-volume centers and 1.5% at the low-volume centers (p = 0.028). Ninety-day mortality was 1.6% at high-volume and 3.6% at low-volume centers (p < 0.001). Median survival was 40 months at high-volume treatment centers compared with 37 months at low-volume centers (p = 0.002). For high-grade tumors, median survival was 30 months and 24 months at high- and low-volume centers, respectively (p = 0.001). Other measures of outcomes were also significantly better at the high-volume centers, the authors note. For lesions larger than 10 cm, median survival was 28 months versus 19 months at high- versus low-volume centers, respectively. The limb amputation rate was markedly different between the two types of treatment centers, at 9.4% for high- and 13.8% for low-volume centers. There was a 54% higher likelihood that radiation and/or chemotherapy would be given at a high-volume center. Treatment at a high-volume center may be difficult to obtain, Dr. Koniaris commented. "Some health care systems are closed and would require an outside referral that might or might not be provided," he told Reuters Health. "Referrals are a problem," he added. "Studies have found, for example, that potentially curable patients with pancreatic cancer are not being referred." Ann Surg 2007;245:952-958. Source: Medscape.com Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.