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Assessment of multimodality therapy use for extremity sarcoma in the United States.

Publication ,  Journal Article
Sherman, KL; Wayne, JD; Chung, J; Agulnik, M; Attar, S; Hayes, JP; Laskin, WB; Peabody, TD; Bentrem, DJ; Pollock, RE; Bilimoria, KY
Published in: J Surg Oncol
April 2014

BACKGROUND: Extremity sarcoma national guidelines offer several stage-specific treatment options; therefore, treatment approaches are not standardized. Our objectives were to examine multimodality treatment trends, practice patterns, and factors associated with neoadjuvant or postoperative adjuvant therapy utilization. METHODS: Using the National Cancer Data Base (2000-2009), treatment of non-metastatic extremity sarcoma was examined. Regression models were developed to identify factors associated with neoadjuvant or postoperative adjuvant therapy receipt and treatment sequence. RESULTS: Twenty-two thousand fifty-one patients underwent resection (stage I: 45.2%, stage II: 27.7%, stage III: 27.1%). Over 10 years, neoadjuvant radiation (6.4-11.6%, P < 0.001) and chemotherapy utilization (1.4-1.8%, P = 0.037) increased, while postoperative radiation (34.3-29.2%, P = 0.023) and trimodality therapy decreased (10.5-9.6%, P = 0.002). After adjusting for age, comorbidities, and histology, patients with large high-grade tumors treated at high-volume academic centers were more likely to receive neoadjuvant therapy (all P < 0.001). Postoperative chemotherapy utilization was associated with younger age, synovial histology, high grade, and surgical margins (all P < 0.001). CONCLUSIONS: Utilization of neoadjuvant therapy for extremity sarcoma has increased over time. Practice patterns are not only related to tumor size, grade, histology, and margins but also hospital type. Opportunities remain to better define the most effective multimodality treatment for extremity sarcoma.

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Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

April 2014

Volume

109

Issue

5

Start / End Page

395 / 404

Location

United States

Related Subject Headings

  • United States
  • Sarcoma, Synovial
  • Sarcoma
  • Retrospective Studies
  • Regression Analysis
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasm Staging
  • Neoplasm Grading
 

Citation

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Sherman, K. L., Wayne, J. D., Chung, J., Agulnik, M., Attar, S., Hayes, J. P., … Bilimoria, K. Y. (2014). Assessment of multimodality therapy use for extremity sarcoma in the United States. J Surg Oncol, 109(5), 395–404. https://doi.org/10.1002/jso.23520
Sherman, Karen L., Jeffrey D. Wayne, Jeanette Chung, Mark Agulnik, Samer Attar, John P. Hayes, William B. Laskin, et al. “Assessment of multimodality therapy use for extremity sarcoma in the United States.J Surg Oncol 109, no. 5 (April 2014): 395–404. https://doi.org/10.1002/jso.23520.
Sherman KL, Wayne JD, Chung J, Agulnik M, Attar S, Hayes JP, et al. Assessment of multimodality therapy use for extremity sarcoma in the United States. J Surg Oncol. 2014 Apr;109(5):395–404.
Sherman, Karen L., et al. “Assessment of multimodality therapy use for extremity sarcoma in the United States.J Surg Oncol, vol. 109, no. 5, Apr. 2014, pp. 395–404. Pubmed, doi:10.1002/jso.23520.
Sherman KL, Wayne JD, Chung J, Agulnik M, Attar S, Hayes JP, Laskin WB, Peabody TD, Bentrem DJ, Pollock RE, Bilimoria KY. Assessment of multimodality therapy use for extremity sarcoma in the United States. J Surg Oncol. 2014 Apr;109(5):395–404.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

April 2014

Volume

109

Issue

5

Start / End Page

395 / 404

Location

United States

Related Subject Headings

  • United States
  • Sarcoma, Synovial
  • Sarcoma
  • Retrospective Studies
  • Regression Analysis
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasm Staging
  • Neoplasm Grading