Primary retroperitoneal sarcoma: A comparison of survival outcomes in specialist and non-specialist sarcoma centres

Background: Consensus guidelines outline that patients with primary retro-peritoneal sarcoma (RPS) should be managed within specialist sarcoma centres (SSC). There is, however, a paucity of population-based data detailing incidence and outcomes in these patients. Hence, we aimed to evaluate patterns of care among RPS patients in England and compare outcomes for those undergoing surgery in high-volume specialist sarcoma centres (HV-SSC), low-volume SSC (LV-SSC), and non-SSC (N-SSC).Methods: Data on patients diagnosed with primary RPS between 2013 and 2018 were ex-tracted from NHS Digital's National Cancer Registration and Analysis Service using the national cancer registration dataset. Diagnostic pathways, treatment, and survival outcomes were compared between HV-SSC, LV-SSC, and N-SSC. Uni-and multivariate analyses were calculated.Results: Of 1878 patients diagnosed with RPS, 1120 (60%) underwent surgery within 12 months of diagnosis, with 847 (76%) operated on at SSC; of these, 432 patients (51%) were operated on in HV-SSC, and 415 (49%) in LV-SSC. One-and 5-year estimated overall survival (OS) rates for patients undergoing surgery in N-SSC were 70.6% (95% confidence interval [CI]: 64.8-75.7) and 42.0% (CI: 35.9-47.9), compared to 85.0% (CI: 81.1-88.1) and 51.7% (CI: 46.6-56.6) in LV-SSC (p < 0.01), and 87.4% (CI: 83.9-90.2) and 62.8% (CI: 57.9-67.4) in HV- SSC, (p < 0.01). After adjusting for patient-and treatment-related factors, patients treated in HV-SSC were found to have significantly longer OS than those treated at LV-SSC, with an adjusted hazard ratio of 0.78 (CI: 0.62-0.96, p < 0.05).Conclusion: Patients with RPS undergoing surgery in HV-SSC have significantly better sur-vival outcomes than those treated in N-SSC and L-SSC.(c) 2023 Elsevier Ltd. All rights reserved.

Automated summary

This study evaluated the treatment patterns and outcomes of RPS patients in England, and found that patients who underwent surgery in specialist sarcoma centers had better survival outcomes compared to those treated in non-specialist centers.