Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 24, 2020; 11(6): 389-396
Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.389
National Comprehensive Cancer Network guidelines compliance of a sarcoma service: A retrospective review
Alan T Blank, Brandon Michael Larson, Sara Shaw, Connor J Wakefield, Tricia King, Kevin B Jones, R Lor Randall
Alan T Blank, Brandon Michael Larson, Connor J Wakefield, Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL 60612, United States
Sara Shaw, Tricia King, Kevin B Jones, Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, United States
R Lor Randall, Department of Orthopedic Surgery, University of California-Davis Medical Center, Sacramento, CA 95817, United States
Author contributions: All authors contributed to this research study; Blank AT performed the procedures; Blank AT, Jones KB, Randall RL contributed to the critical revision of manuscript, conception and design, and project supervision; Larson BM and Wakefield CJ contributed to the analysis and interpretation of data; Shaw S, Larson BM and Wakefield CJ wrote the manuscript.
Institutional review board statement: This study was reviewed and approved by the University of Utah Medical Center Institutional Review Board and Research Integrity and Compliance office.
Informed consent statement: Patients were not required to give informed consent for this retrospective study. All data obtained and used for analysis remained anonymous and was obtained through routine clinical care.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Alan T Blank, MD, MSc, Assistant Professor, Attending Doctor, Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, United States. alan.blank@rushortho.com
Received: February 20, 2020
Peer-review started: February 20, 2020
First decision: April 25, 2020
Revised: May 9, 2020
Accepted: May 19, 2020
Article in press: May 19, 2020
Published online: June 24, 2020
Processing time: 125 Days and 8.7 Hours
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.

Keywords: Soft tissue sarcoma; Bony sarcoma; Orthopedic; Oncology; Sarcoma guidelines; National Comprehensive Cancer Network

Core tip: Clinical practice guidelines are necessary to ensure patients are treated equally and appropriately across all scenarios. This study is the first to investigate provider’s compliance with the National Comprehensive Cancer Network (NCCN) guidelines on sarcoma. The findings from this study demonstrate that compliance with NCCN sarcoma guidelines is high within a single National Cancer Institute designated center. Although in other cancer diagnoses improved survival has been documented with compliance of NCCN guidelines it is currently unknown whether this observation applies to sarcoma. We feel this manuscript will encourage future research in the impact of NCCN guidelines on the outcomes of patients with sarcoma who are treated at both National Cancer Institute designated and non-designated centers.