PDF(Pubmed)
Abstract：
Sarcoma treatment requires a high level of expertise due to its rarity and heterogeneity. Sarcoma patients should, therefore, be referred to an expert centre as early as possible to ensure optimal treatment. Numerous studies have been carried out to provide evidence for this strategy. In compliance with the 2020 PRISMA guidelines, a systematic search was conducted in PubMed, EMBASE, Ovid Medline, ClinicalTrials.gov and Cochrane Library databases. The subject of these studies was the centralised treatment of adult sarcoma patients at expert centres and the use of interdisciplinary tumour boards. Uncertainty in therapy, delays in referral to expert centres, and limited access to therapeutic modalities continue to be a challenge in sarcoma therapy. At expert centres, diagnostic procedures were more frequently and adequately performed, and treatment was associated with an improvement in outcomes in the majority of studies: patients benefited from longer survival, lower local recurrence rates and a better postoperative outcome. The implementation of an interdisciplinary tumour board was associated with discrepant results. In a greater number of studies, it was associated with a lower local relapse rate, better overall survival and surgical outcome. In two studies, however, a shorter overall survival was observed. The establishment of expert centres and the consistent use of interdisciplinary tumour boards are important structures for ensuring multidisciplinary therapy approaches. There is growing evidence that this holds great potential for optimising sarcoma therapy.
摘要：
由于肉瘤的稀有性和异质性，治疗需要高水平的专业知识。肉瘤患者应该，因此,尽早转到专家中心，以确保最佳治疗。已经进行了许多研究来为该策略提供证据。根据2020年PRISMA指南，在PubMed进行了系统的搜索，EMBASE,OvidMedline,ClinicalTrials.gov和Cochrane图书馆数据库。这些研究的主题是在专家中心对成年肉瘤患者进行集中治疗以及使用跨学科肿瘤委员会。治疗的不确定性，延迟转介专家中心，有限的治疗方法仍然是肉瘤治疗的挑战。在专家中心，诊断程序更频繁和充分地执行，在大多数研究中，治疗与结局的改善有关：患者受益于更长的生存期，较低的局部复发率和更好的术后预后。跨学科肿瘤委员会的实施与不同的结果有关。在更多的研究中，它与较低的局部复发率有关，更好的总生存率和手术结果。在两项研究中，然而,观察到较短的总生存期.专家中心的建立和跨学科肿瘤委员会的一致使用是确保多学科治疗方法的重要结构。越来越多的证据表明，这对于优化肉瘤治疗具有巨大的潜力。
