Blank AT, Larson BM, Shaw S, Wakefield CJ, King T, Jones KB, Randall RL. National Comprehensive Cancer Network guidelines compliance of a sarcoma service: A retrospective review. World J Clin Oncol 2020; 11(6): 389-396 [PMID: 32874952 DOI: 10.5306/wjco.v11.i6.389]
Corresponding Author of This Article
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
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
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
ARTICLE HIGHLIGHTS
Research background
National Comprehensive Cancer Network (NCCN) guidelines are imperative to ensure patients receive uniform and quality care. Reports have found a positive association between compliance of these guidelines and clinical outcomes in various malignancies. It is unknown whether large volume centers follow the NCCN guidelines when treating patients with sarcoma.
Research motivation
This study aims to investigate the compliance of a large National Cancer Institute (NCI) designated center with NCCN guidelines for the treatment of sarcoma. Deviation from these guidelines are important to acknowledge when attempting to improve patient outcomes.
Research objectives
The primary objective of this study was to identify the compliance rate of our center with NCCN sarcoma guidelines. If deviation from these guidelines were observed it was then necessary to identify factors associated with non-adherence to NCCN guidelines.
Research methods
This study was a retrospective review of prospectively collected data obtained through routine medical care at a single orthopedic oncology outpatient clinic.
Research results
Overall, NCCN guidelines on bone and soft tissue sarcoma were followed appropriately in 94% of cases reviewed. It was identified that there was a delay in obtaining staging chest imaging in one patient with giant cell tumor and lack of obtaining pre-resection tissue biopsy in a patient with chondrosarcoma.
Research conclusions
We are the first study to investigate compliance with NCCN sarcoma guidelines at a large NCI designated center. Although we report a high rate of overall compliance, we identified non-adherence with NCCN guidelines in 2 patients. Further research is required to determine if compliance with NCCN sarcoma guidelines is associated with improve patient outcomes.
Research perspectives
NCCN guidelines establish evidence and consensus based guidelines for the diagnostic evaluation and treatment of many different malignancies. There are several reports detailing rates of NCCN compliance and the improved patient outcomes with adherence to these guidelines. Further research is needed to determine if other NCI designated and non-designated centers share our reported compliance with NCCN sarcoma guidelines and to what degree patient outcomes are affected when there is deviation from these guidelines.
