Jakob J, Gerres A, Ronellenfitsch U, Pilz L, Wartenberg M, Kasper B, Raab H-R, Hohenberger P
Spezielle Chirurgische Onkologie und Thoraxchirurgie, Chirurgische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68137, Mannheim, Deutschland.
Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland.
Chirurg. 2018 Jan;89(1):50-55. doi: 10.1007/s00104-017-0504-2.
Retroperitoneal sarcomas (RPSs) are rare cancers with some variability in clinical and histopathological presentation. In Germany, general treatment strategies of retroperitoneal sarcoma are unknown since centralized registries do not exist. The objective of this survey was to access the medical care of RPS patients in Germany.
In cooperation with the German Society of General and Visceral surgery, the German Interdisciplinary Sarcoma Study Group and the patient advocacy group Das Lebenshaus we designed an online survey assessing diagnostic and treatment strategies (e. g. performance of tumor biopsies, administration of multimodal therapies and surgical strategy). All departments for general and visceral surgery in Germany were addressed (n = 976).
Responses were received from 191 of 976 departments. Only 11 surgical departments treat more than 10 RPS patients per year. A multidisciplinary sarcoma board exists in 19 hospitals. Staging is generally performed by cross-sectional imaging. In 54% of the departments pretreatment tumor biopsy is a standard procedure. Surgery is performed as compartment resection in 85% of the departments. A systematic lymph node dissection is done in 40%. Adjuvant radio- or chemotherapy is performed as a standard treatment in 27% and 22% departments, respectively.
The survey demonstrates a large heterogeneity in RPS diagnostic and treatment strategies. Dedicated education programs and centralized treatment strategies are warranted to improve the standard of care.
腹膜后肉瘤(RPS)是一种罕见的癌症,其临床和组织病理学表现存在一定差异。在德国,由于缺乏集中登记系统,腹膜后肉瘤的一般治疗策略尚不清楚。本次调查的目的是了解德国RPS患者的医疗情况。
我们与德国普通外科和内脏外科学会、德国跨学科肉瘤研究组以及患者倡导组织Das Lebenshaus合作,设计了一项在线调查,以评估诊断和治疗策略(例如肿瘤活检的实施情况、多模式治疗的应用以及手术策略)。我们向德国所有普通外科和内脏外科科室(共976个)发送了调查问卷。
976个科室中有191个回复了问卷。每年仅11个外科科室治疗超过10例RPS患者。19家医院设有多学科肉瘤委员会。分期通常通过横断面成像进行。54%的科室将治疗前肿瘤活检作为标准程序。85%的科室进行间室切除术。40%的科室进行系统性淋巴结清扫。分别有27%和22%的科室将辅助放疗或化疗作为标准治疗。
该调查表明RPS的诊断和治疗策略存在很大异质性。有必要开展专门的教育项目并制定集中治疗策略,以提高医疗水平。