Outcome
Clinical area
Local recurrence/overall survival
Quality of life
Cost
Multidisciplinary consultation
?
NA
?
Guideline oriented care
?
NA
Lower
Regionalization of sarcoma care
Improved
Improved
?
Soft tissue extremity sarcoma
Neoadjuvant chemotherapy
Not improved
Similar
?
Neoadjuvant chemoradiation
Not improved
Similar
?
Adjuvant chemotherapy
Modest improvement in selected patients
?
?
Adjuvant radiation
Improved local control
Worse
Higher
Neoadjuvant radiation
Equivalent local control
Improved
?
Brachytherapy
Improved local control
?
?
Radiation modality
?
?
?
Surgery for local recurrence
Improved
?
?
Retroperitoneal sarcoma
Preoperative biopsy
NA
NA
?
Radical compartment surgery
?
?
?
Radiation
?
?
?
Surveillance
?
?
?
References
1.
NCCN clinical practice guidelines in oncology (NCCN)—soft tissue sarcoma 2013. Available at www.nccn.org
2.
3.
4.
Ray-Coquard I, Thiesse P, Ranchere-Vince D et al (2004) Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas. Ann Oncol Official J Eur Soc Med Oncol/ESMO 15(2):307–315CrossRef
5.
Jansen-Landheer ML, Krijnen P, Oostindier MJ et al (2009) Improved diagnosis and treatment of soft tissue sarcoma patients after implementation of national guidelines: a population-based study. Eur J Surg Oncol J Eur Soc Surg Oncol Brit Assoc Surg Oncol 35(12):1326–1332
6.
7.
Perrier L, Buja A, Mastrangelo G et al (2012) Clinicians’ adherence versus non adherence to practice guidelines in the management of patients with sarcoma: a cost-effectiveness assessment in two European regions. BMC Health Serv Res 12:82CrossRefPubMedCentralPubMed
8.
Gutierrez JC, Perez EA, Moffat FL et al (2007) Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients. Ann Surg 245(6):952–958CrossRefPubMedCentralPubMed
9.
Clasby R, Tilling K, Smith MA et al (1997) Variable management of soft tissue sarcoma: regional audit with implications for specialist care. Br J Surg 84(12):1692–1696CrossRefPubMed

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