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个性化肉瘤护理(PERSARC)预测模型对多学科环境下临床决策的影响

The Influence of Personalised Sarcoma Care (PERSARC) Prediction Modelling on Clinical Decision Making in a Multidisciplinary Setting.

作者信息

Hagenmaier H S Femke, van Beeck Annelies G K, Haas Rick L, van Praag Veroniek M, van Bodegom-Vos Leti, van der Hage Jos A, Krol Stijn, Speetjens Frank M, Cleven Arjen H G, Navas Ana, Kroon Herman M, Moeri-Schimmel Rieneke G, Leyerzapf Nicolette A C, van de Sande Michiel A J

机构信息

Department of Orthopaedic Surgery, Sint Maartenskliniek, Hengstdal 3, 6574 NA Ubbergen, Netherlands.

Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, Netherlands.

出版信息

Sarcoma. 2021 Oct 21;2021:8851354. doi: 10.1155/2021/8851354. eCollection 2021.

Abstract

BACKGROUND

With soft-tissue sarcoma of the extremity (ESTS) representing a heterogenous group of tumors, management decisions are often made in multidisciplinary team (MDT) meetings. To optimize outcome, nomograms are more commonly used to guide individualized treatment decision making.

PURPOSE

To evaluate the influence of Personalised Sarcoma Care (PERSARC) on treatment decisions for patients with high-grade ESTS and the ability of the MDT to accurately predict overall survival (OS) and local recurrence (LR) rates.

METHODS

Two consecutive meetings were organised. During the first meeting, 36 cases were presented to the MDT. OS and LR rates without the use of PERSARC were estimated by consensus and preferred treatment was recorded for each case. During the second meeting, OS/LR rates calculated with PERSARC were presented to the MDT. Differences between estimated OS/LR rates and PERSARC OS/LR rates were calculated. Variations in preferred treatment protocols were noted.

RESULTS

The MDT underestimated OS when compared to PERSARC in 48.4% of cases. LR rates were overestimated in 41.9% of cases. With the use of PERSARC, the proposed treatment changed for 24 cases.

CONCLUSION

PERSARC aids the MDT to optimize individualized predicted OS and LR rates, hereby guiding patient-centered care and shared decision making.

摘要

背景

肢体软组织肉瘤(ESTS)是一组异质性肿瘤,治疗决策通常在多学科团队(MDT)会议上做出。为了优化治疗结果,更常使用列线图来指导个体化治疗决策。

目的

评估个性化肉瘤护理(PERSARC)对高级别ESTS患者治疗决策的影响以及MDT准确预测总生存期(OS)和局部复发(LR)率的能力。

方法

组织了两次连续的会议。在第一次会议期间,向MDT展示了36例病例。通过共识估计不使用PERSARC时的OS和LR率,并记录每个病例的首选治疗方法。在第二次会议期间,向MDT展示了用PERSARC计算的OS/LR率。计算估计的OS/LR率与PERSARC的OS/LR率之间的差异。记录首选治疗方案的变化。

结果

与PERSARC相比,MDT在48.4%的病例中低估了OS。在41.9%的病例中高估了LR率。使用PERSARC后,24例病例的建议治疗方案发生了变化。

结论

PERSARC有助于MDT优化个体化预测的OS和LR率,从而指导以患者为中心的护理和共同决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a010/8553471/68945b92187a/sarcoma2021-8851354.001.jpg

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