Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.389
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
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.
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.
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.
This study was a retrospective review of prospectively collected data obtained through routine medical care at a single orthopedic oncology outpatient clinic.
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.
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.
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.