Bisogno Gianni, Congiu Giovanna, Affinita Maria Carmen, Milano Giuseppe Maria, Zanetti Ilaria, Coppadoro Beatrice, Manzitti Carla, Basso Eleonora, Tamburini Angela, Melchionda Fraia, Cellini Monica, Pericoli Roberta, D'Angelo Paolo, Cataldo Andrea Di, De Leonardis Francesco, Rabusin Marco, De Corti Federica, Zin Angelica, Alaggio Rita, Scarzello Giovanni, Ferrari Andrea
Hematology Oncology Division, Department of Women's and Children's Health, Padova University Hospital, Padua, Italy.
Pediatric Hematology Oncology, Ospedale Microcitemico "A. Cao," A.O. Brotzu, Cagliari, Italy.
Pediatr Blood Cancer. 2021 Dec;68(12):e29234. doi: 10.1002/pbc.29234. Epub 2021 Jul 14.
The survival of children with rhabdomyosarcoma (RMS) has gradually improved as a result of the adoption of multidisciplinary treatments. Dedicated skills and facilities are indispensable and more readily available at reference centers. In this study, we examined the role of centers' experience (based on the number of patients treated) in their management of patients with RMS.
We analyzed 342 patients with localized RMS enrolled in the European RMS 2005 protocol from October 2005 to December 2016 at 31 Italian centers that are part of the Soft Tissue Sarcoma Committee (STSC). We grouped the centers by the number of patients each one enrolled (Group 1: >40; Group 2: <40 and >10; and Group 3: <10), and compared a number of indicators to assess the appropriateness of patients' diagnostic workup and treatment and their survival.
Overall, 74.6% of patients were treated at 10 centers, and only three of them classifiable as high-volume centers. Only minor differences emerged between the three patient groups in terms of diagnostic investigations and treatment modalities. Survival was similar in the three groups. Approximately, one in four children treated at the centers in Groups 2 and 3 traveled to another center for surgery or radiotherapy.
Patients treated at STSC centers with different amounts of experience had similar results in terms of survival. This is attributable to all centers in the network adhering to protocol recommendations and receiving the STSC's support on diagnostics and multidisciplinary treatments for RMS.
由于采用了多学科治疗方法，横纹肌肉瘤（RMS）患儿的生存率逐渐提高。专业技能和设施是必不可少的，且在参考中心更容易获得。在本研究中，我们考察了中心经验（基于治疗患者数量）在RMS患者管理中的作用。
我们分析了2005年10月至2016年12月期间在31个意大利中心登记参加欧洲RMS 2005方案的342例局限性RMS患者，这些中心是软组织肉瘤委员会（STSC）的成员。我们根据每个中心登记的患者数量对中心进行分组（第1组：>40例；第2组：<40例且>10例；第3组：<10例），并比较了一些指标，以评估患者诊断检查和治疗的适宜性及其生存率。
总体而言，74.6%的患者在10个中心接受治疗，其中只有3个可归类为大容量中心。三组患者在诊断检查和治疗方式方面仅出现微小差异。三组的生存率相似。在第2组和第3组中心接受治疗的儿童中，约四分之一的人前往另一个中心进行手术或放疗。
在STSC中心接受治疗的经验不同的患者在生存率方面结果相似。这归因于网络中的所有中心都遵守方案建议，并在RMS的诊断和多学科治疗方面获得了STSC的支持。
