No Geographical Inequalities in Survival for Sarcoma Patients in France: A Reference Networks’ Outcome?

Cancers

Jean-Christophe Ruzic¹  Hélène Labrosse²  Fadila Farsi²  Agnes Ducoulombier³  Sylvain Causeret⁴  Daniel Orbach⁵  Sylvie Chabaud⁶  Cécile Dalban⁶  Pauline Soibinet⁷  Loïc Chaigneau⁸  Florence Duffaud⁹  Maria Rios^1,10  Isabelle Ray-Coquard^1,11  Jean-Yves Blay^1,12  François Bertucci^1,13  Aurore Vozy^1,14  Justine Gantzer^1,15  Louis-Romée Le Nail^1,16  François Le Loarer^1,17  Jean-Michel Coindre^1,17  Marie Karanian^1,18  Pierre Meeus^1,19  François Gouin^1,19  Charles Honoré^2,20  Sylvie Bonvalot^2,21  Gauthier Decanter^2,22  Olivier Collard^2,23  Yohan Fayet^2,24  Françoise Ducimetière^2,25  Christine Chevreau^2,26  Gwenaël Ferron^2,27  Sébastien Carrère^2,28  Raphaël Tétreau^2,29  Emmanuelle Bompas^3,30  Axel Le Cesne^3,31  Pascale Dubray-Longeras^3,32  Mickaël Ropars^3,33  Michelle Kind^3,34  Leila Haddag-Miliani^3,35  Paul Michelin^3,36  Valérie Le Brun Ly^3,37  Clément Bonnet^3,38  Camille Tlemsani^3,39  Sabine Noal^4,40 

[1] CHU Réunion, 97410 Saint-Pierre, France;CRLCC Léon Berard, Oncology Regional Network ONCO-AURA, 69008 Lyon, France;Centre Antoine-Lacassagne, 06000 Nice, France;Centre Georges François Leclerc, 21000 Dijon, France;Centre Oncologie SIREDO (Soins, Innovation et Recherche en Oncologie de l’Enfant, de l’aDOlescents et de L’adulte Jeune), Institut Curie, Université de Recherche Paris Sciences et Lettres, 75005 Paris, France;Department of Clinical Research and Innovation, Centre Léon Bérard, 69008 Lyon, France;Department of Hepato-Gastroenterology and Digestive Oncology, Reims University Hospital, 51000 Reims, France;Department of Medical Oncology, CHRU Jean Minjoz, 25000 Besançon, France;Department of Medical Oncology, CHU La Timone and Aix-Marseille Université (AMU), 13005 Marseille, France;Department of Medical Oncology, Cancer Institute of Lorraine-Alexis Vautrin, 54500 Vandoeuvre Les Nancy, France;Department of Medical Oncology, Centre Leon Berard, 69008 Lyon, France;Department of Medical Oncology, Centre Léon Bérard, Lyon University, 69008 Lyon, France;Department of Medical Oncology, Institut Paoli-Calmettes, 13009 Marseille, France;Department of Medical Oncology, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Universitaire de Cancérologie (IUC), CLIP(2) Galilée, Sorbonne University, 75013 Paris, France;Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 67033 Strasbourg, France;Department of Orthopaedic Surgery, CHU de Tours, Faculté de Médecine, Université de Tours, 37000 Tours, France;Department of Pathology, Institut Bergonié, 33000 Bordeaux, France;Department of Pathology, Lyon University Hospital, 69008 Lyon, France;Department of Surgery, Centre Léon Bérard, 69008 Lyon, France;Department of Surgical Oncology, Gustave Roussy, Villejuif 94800, France;Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, 75005 Paris, France;Department of Surgical Oncology, Oscar Lambret Center, 59000 Lille, France;Département d’Oncologie Médicale, Hôpital Privé de la Loire, 42100 Saint-Etienne, France;EMS Team–Human and Social Sciences Department, Centre Léon Bérard, 69008 Lyon, France;Equipe EMS, Centre Léon Bérard, 69008 Lyon, France;ICR IUCT-Oncopole, 31000 Toulouse, France;INSERM CRCT19 ONCO-SARC (Sarcoma Oncogenesis), Institut Claudius Regaud-Institut Universitaire du Cancer, 31000 Toulouse, France;Institut de Recherche en Cancérologie Montpellier, INSERM U1194, 34000 Montpellier, France;Medical Imaging Center, Institut du Cancer, 34000 Montpellier, France;Medical Oncology Department, ICO, 44800 Saint Herblain, France;Medical Oncology, Insitut Gustave Roussy, 94800 Villejuif, France;Oncology Department, Centre Jean Perrin, 63011 Clermont-Ferrand, France;Orthopaedic and Trauma Department, Pontchaillou University Hospital, University of Rennes 1, 35000 Rennes, France;Radiologue, Département D’imagerie Médicale, Institut Bergonié, 33000 Bordeaux, France;Service D’imagerie Diagnostique, Institut Gustave Roussy, 94800 Villejuif, France;Service D’imagerie Médicale, CHU Hopitaux de Rouen-Hopital Charles Nicolle, 76000 Rouen, France;Service D’oncologie Médicale, CHU Dupuytren, 87000 Limoges, France;Service d’Oncologie Médicale Hôpital Saint Louis, 75010 Paris, France;Service d’Oncologie Médicale, Hôpital Cochin, Institut du Cancer Paris CARPEM, Université de Paris, APHP Centre, 75014 Paris, France;UCP Sarcome, Centre François Baclesse, 14000 Caen, France;

关键词: spatial inequalities;    reference networks;    remoteness;    social deprivation;    rare cancers;    France;   

DOI  :  10.3390/cancers14112620

来源: DOAJ

【 摘 要 】

The national reference network NETSARC+ provides remote access to specialized diagnosis and the Multidisciplinary Tumour Board (MTB) to improve the management and survival of sarcoma patients in France. The IGéAS research program aims to assess the potential of this innovative organization to address geographical inequalities in cancer management. Using the IGéAS cohort built from the nationwide NETSARC+ database, the individual, clinical, and geographical determinants of the 3-year overall survival of sarcoma patients in France were analyzed. The survival analysis was focused on patients diagnosed in 2013 (n = 2281) to ensure sufficient hindsight to collect patient follow-up. Our study included patients with bone (16.8%), soft-tissue (69%), and visceral (14.2%) sarcomas, with a median age of 61.8 years. The overall survival was not associated with geographical variables after adjustment for individual and clinical factors. The lower survival in precarious population districts [HR 1.23, 95% CI 1.02 to 1.48] in comparison to wealthy metropolitan areas (HR = 1) found in univariable analysis was due to the worst clinical presentation at diagnosis of patients. The place of residence had no impact on sarcoma patients’ survival, in the context of the national organization driven by the reference network. Following previous findings, this suggests the ability of this organization to go through geographical barriers usually impeding the optimal management of cancer patients.

【 授权许可】

Unknown