Management and outcomes of adolescent and young adult sarcoma patients: results from the French nationwide database NETSARC.

P. Kubicek (1, 2) , A. L. Cesne (3) , C. Lervat (4) , M. Toulmonde (5) , C. Chevreau (6) , F. Duffaud (7) , L. R. Le Nail (8) , M. Morelle (2) , N. Gaspar (3) , C. Vérité (5) , M. P. Castex (9) , Nicolas Penel (4) , E. Saada (10) , S. Causeret (11) , F. Bertucci (12) , C. Perrin (13) , E. Bompas (1) , D. Orbach (14) , V. Laurence (14) , S. Piperno-Neumann (14) , P. Anract (15) , M. Rios (16) , J. C. Gentet (7) , É. Mascard (17) , S. Pannier (17) , P. Blouin (8) , S. Carrère (18, 19) , L. Chaigneau (20) , P. Soibinet-Oudot (21) , N. Corradini (22) , P. Boudou-Rouquette (15) , J. C. Ruzic (23) , V. Lebrun-Ly (24) , P. Dubray-Longeras (25) , S. Varatharajah (26) , C. Lebbe (27) , M. Ropars (28) , J. E. Kurtz (29) , C. Guillemet (30) , J. P. Lotz (31) , J. Berchoud (32) , G. Cherrier (8) , F. Ducimetière (2) , C. Chemin (2) , A. Italiano (5, 3) , C. Honoré (3) , E. Desandes (33, 34) , J. Y. Blay (2) , F. Gouin (2, 32) , P. Marec-Bérard (2, 22)

1 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
2 Centre Léon Bérard [Lyon]
3 IGR - Institut Gustave Roussy
4 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
5 Institut Bergonié [Bordeaux]
6 ICR - Institut Claudius Regaud
7 TIMONE - Hôpital de la Timone [CHU - APHM]
8 CHU Trousseau [Tours]
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
11 Service de chirurgie [Centre Georges-François Leclerc]
12 IPC - Institut Paoli-Calmettes
13 CRLCC - CRLCC Eugène Marquis
14 Institut Curie [Paris]
15 Hôpital Cochin [AP-HP]
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 Hôpital Necker - Enfants Malades [AP-HP]
18 ICM - Institut régional de Cancérologie de Montpellier
19 ICM - UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle
20 Service d'Oncologie Médicale [CHRU Besançon]
21 Institut Jean Godinot [Reims]
22 IHOPe - Institut d'hématologie et d'oncologie pédiatrique [CHU - HCL]
23 Centre Hospitalier de Mayotte
24 Hôpital Dupuytren [CHU Limoges]
25 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
26 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
27 AP-HP - Hopital Saint-Louis [AP-HP]
28 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
29 ICANS - Institut de Cancérologie de Strasbourg Europe
30 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
31 CHU Tenon [AP-HP]
32 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
33 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques
34 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy

Background The initial management of patients with sarcoma is a critical issue. We used the nationwide French National Cancer Institute-funded prospective sarcoma database NETSARC to report the management and oncologic outcomes in adolescents and young adults (AYAs) patients with sarcoma at the national level. Patients and methods NETSARC database gathers regularly monitored and updated data from patients with sarcoma. NETSARC was queried for patients (15–30 years) with sarcoma diagnosed from 2010 to 2017 for whom tumor resection had been performed. We reported management, locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) in AYA treated in French reference sarcoma centers (RSC) and outside RSC (non-RSC) and conducted multivariable survival analyses adjusted for classical prognostic factors. Results Among 3,227 patients aged 15–30 years with sarcoma diagnosed between 2010 and 2017, the study included 2,227 patients with surgery data available, among whom 1,290 AYAs had been operated in RSC, and 937 AYAs in non-RSC. Significant differences in compliance to guidelines were observed including pre-treatment biopsy (RSC: 85.9%; non-RSC 48.1%), pre-treatment imaging (RSC: 86.8%; non-RSC: 56.5%) and R0 margins (RSC 57.6%; non-RSC: 20.2%) (p < 0.001). 3y-OS rates were 81.1% (95%CI 78.3–83.6) in AYA in RSC and 82.7% (95%CI 79.4–85.5) in AYA in non-RSC, respectively. Whereas no significant differences in OS was observed in AYAs treated in RSC and in non-RSC, LRFS and PFS were improved in AYAs treated in RSC compared to AYAs treated in non-RSC (Hazard Ratios (HR): 0.58 and 0.83, respectively). Conclusions This study highlights the importance for AYA patients with sarcoma to be managed in national sarcoma reference centers involving multidisciplinary medical teams with paediatric and adult oncologists.

Mots clés: NETSARC; Adolescents and young adults; AYAs; Sarcoma; Management; Multidisciplinary tumor board; Reference centers; Survival

Domaines: Sciences du Vivant [q-bio]

P. Kubicek, A. L. Cesne, C. Lervat, M. Toulmonde, C. Chevreau, et al.. Management and outcomes of adolescent and young adult sarcoma patients: results from the French nationwide database NETSARC.. BMC Cancer, 2023, BMC Cancer, 23 (1), pp.69. ⟨10.1186/s12885-023-10556-4⟩. ⟨hal-04315885⟩