{Reference Type}: Journal Article
{Title}: [Evaluation of the management and conformity to clinical practice guidelines of soft tissues lesions. Study performed at the competence center of Lorraine area].
{Author}: Genet J;Salleron J;Leroux A;Verhaeghe JL;Simon E;
{Journal}: Ann Chir Plast Esthet
{Volume}: 64
{Issue}: 4
{Year}: Aug 2019
{Factor}: 0.75
{DOI}: 10.1016/j.anplas.2018.10.001
{Abstract}: <B>BACKGROUND: </B>Despite regular recommendations issued by the European Society for Medical Oncology (ESMO), patients faced still too often inadequate care with a direct influence on prognosis.<BR><B>METHODS: </B>A retrospective study was carried out at the Competence center in Lorraine Area. Patients registered in the NetSarc database between 1st, 2010 and September 1st, 2016 were included. Compliance criteria were established using the latest ESMO 2014 referential. Two groups "conforming" and "non conforming" were analyzed. A first analyze about all of the soft tissue lesion and a second only about sarcomas.<BR><B>RESULTS: </B>In total, 445 patients were eligible, 344 cases were treated according to the ESMO guidelines, giving a 77.3% conformity rate (95% CI: 73.4%, 81.2%). Compliance was better for the competence center than district hospitals (P<0.001), with compliance rates of 88.7%, and 51.6%, respectively. Among the 247 sarcomas, we found a R0 resection rate better according to the ESMO guideline, 55% against 18% (P<0.001). R1 rates were 34% vs. 56% and R2 11 vs. 26% disease free survival was not related significantly to the observance of recommendations in the univariate analysis. After adjustment on potential DFS prognostic factors, in the multivariate analysis, the results were similar.<BR><B>CONCLUSIONS: </B>Compliance with the ESMO guidelines, through appropriate management, improves the quality of surgical excision for sarcomas and avoids non-corresponding surgical gestures.