Impact of centralization in primary retroperitoneal sarcoma treatment: analysis using hospital-based cancer registry data in Japan

Int J Clin Oncol. 2020 Sep;25(9):1687-1694. doi: 10.1007/s10147-020-01709-7. Epub 2020 May 25.

Abstract

Background: To elucidate the clinicopathological features, hospital-based care volume and prognoses associated with primary retroperitoneal sarcoma (PRS).

Methods: Clinical data on PRS cases, diagnosed from 2008 to 2009 (cohort A) and from 2012 to 2015 (cohort B), were obtained from the national hospital-based cancer registry in Japan. Since data on survival, 5 years after PRS diagnosis, were available only for cohort A, patient prognoses were analyzed in this group alone.

Results: The numbers of participating hospitals were 154 in cohort A and 537 in cohort B. In total, 380 and 2011 patients with PRS were identified in cohorts A and B, respectively. The incidence of PRS among all the registered urogenital malignancies was 0.52% (2391/462,866). Liposarcoma was the most commonly observed PRS subtype (55.8%), followed by leiomyosarcoma (19.0%). In cohort A, the 5-year overall survival (OS) was 40.4%. The 5-year OS associated with stage I (n = 107), stages II and III (n = 61), and stage IV (n = 59) disease were 59%, 39%, and 6%, respectively. Only two institutions treated over ten patients per year in each cohort. When institutions were divided by hospital care volume (8 hospitals with ≥ = 3 cases and 149 with < 3 cases/year), there were any statistic differences in the OS.

Conclusions: We presented the distribution and prognoses associated with PRS using a real-world large cohort database. Centralization for PRS management was not established in Japan, while the prognosis did not significantly depend on the treatment volume of hospitals.

Keywords: Registries; Soft tissue sarcoma; Urology.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Hospitals / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Japan / epidemiology
  • Leiomyosarcoma / mortality
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / therapy
  • Liposarcoma / mortality
  • Liposarcoma / pathology
  • Liposarcoma / therapy
  • Male
  • Middle Aged
  • Prognosis
  • Registries
  • Retroperitoneal Neoplasms / mortality*
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / therapy
  • Sarcoma / mortality*
  • Sarcoma / pathology
  • Sarcoma / therapy
  • Treatment Outcome
  • Young Adult