Improved diagnosis and treatment of soft tissue sarcoma patients after implementation of national guidelines: A population-based study

Abstract

The compliance with the guidelines has been optimised by the increased attention to this group of patients. Most important factors have been the reporting of the results of the first evaluation and (discussions about) the centralisation of treatment. Further improvements could be reached by the prospective web based registry monitoring logistic aspects as well as parameters useful for the evaluation of the quality of care.

Comparison between MRI with spin-echo echo-planar diffusion-weighted sequence (DWI) and histology in the diagnosis of soft-tissue tumours

“…The emerging applications of DWI in oncology involve tumour characterization [13] and have achieved the best results in the brain [1,2] and liver [4][5][6]. However, most published studies have focused on DWI effi cacy for follow-up after treatment [5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], particularly to predict the response to chemotherapy for sarcomas [14,15] and the possibility of discriminating between tumour recurrence and necrosis in musculoskeletal tumours, which are particularly prone to recurrence after surgery [17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

“…Tuttavia in Letteratura la maggior parte dei lavori sono incentrati sull'effi cacia del DWI nel follow-up post-terapia [5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], in particolare nella premolecules are freer to move (high diffusion coeffi cient) -show a signal loss with increasing b values. Conversely, lesions with a high grade of biological aggressiveness, dizione della risposta dei sarcomi alla chemioterapia, come dimostrano alcuni risultati preliminari [14,15], e nella possibilità di discriminare tra recidiva e necrosi tumorale nello studio dei tumori del sistema muscoloscheletrico, data la frequenza delle recidive post-chirurgiche [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. L'ADC, come già ampiamente dimostrato in altri distretti, è strettamente legato al grado di cellularità del tumore [1,2,22,31].…”

Gross examination and reporting of soft tissue tumours: evaluation of compliance with the UK Royal College of Pathologists soft tissue sarcoma dataset

“…This is in accordance with a study in the Netherlands in 2009, which assessed 79 patients who had soft tissue sarcomas excised in 1998–1999 (before implementation of national guidelines in 2004 aimed at improving diagnostic quality and treatment of patients with soft tissue sarcoma) and 40 in 2006. In 2006, nearly all pathology reports mentioned tumour size, morphology, grade and margins, a major improvement from previously, when 14%–40% of reports did not mention these 34. Potential additional information in reports for soft tissue sarcoma might include the documentation of the nature of consented fresh material sampled, frozen and stored for molecular genetics, and in future a sarcoma service might require an integrated report incorporating histopathological and molecular genetic information.…”

Routes to Diagnosis for Suspected Sarcoma: The Impact of Symptoms and Clinical Findings on the Diagnostic Process

“…Fast track referral pathways have been implemented in some countries to reduce delays [16–18], and the Danish Cancer Patient Pathways (CPPs) have reduced time between referral to a specialized sarcoma center and initiation of treatment in sarcoma patients [19]. However, this is only a small part of the pathway as the main part of the diagnostic route lies with the patient, the general practitioner (GP), and local hospitals.…”