Abstract
BackgroundReports on the epidemiology and mortality of retroperitoneal soft tissue sarcoma (RSTS) in Switzerland are scarce. This study investigates the incidence and outcomes of surgically treated RSTS inpatients in Switzerland depending on the hospital type and size.MethodsData from the Swiss Federal Statistical Office were used to conduct a retrospective analysis of all RSTS inpatients and hospitalizations in Switzerland between 2005 and 2015. RSTS was identified by the code C48.x of the International Classification of Diseases (ICD-10). Sarcoma centers were identified by the annual total number of sarcoma patients (> 50 patients/year). The analysis of yearly incidence, age distribution as well as in-hospital complication and mortality was performed for non- and surgical-treated patients. A centralization of treating sarcoma patients was analyzed by the trend of hospitalizations in sarcoma centers and high-volume hospitals.ResultsDuring 2005–2015, 2.801 hospitalizations (1651 patients) were admitted to Swiss hospitals with the primary diagnosis of a RSTS. The yearly number of RSTS patients and the incidence (1.91/100.000) stayed constant within these 11 years. There were five sarcoma centers. We saw a clear trend of RSTS patients being treated (especially surgically) in centers over the 11 years. The complication rate of surgical-treated patients was higher in sarcoma centers (55% vs. 40%), though the overall mortality rate was lower (3.2% vs. 9.1%).ConclusionCentralization of RSTS treatment to certified sarcoma centers leads to a lower overall mortality rate and thus is highly recommended.
Highlights
In Europe, the incidence of sarcoma is 5.6 per 100,000 people per year
This study investigates the incidence and outcomes of surgically treated retroperitoneal soft tissue sarcoma (RSTS) inpatients in Switzerland depending on the hospital type and size
We found a significant increase in hospitalizations in high-volume hospital (HVH) from 2005 to 2015, with 68% of all RSTS patients being hospitalized in HVH in 2005 and 82% in 2015 (p = 0.005)
Summary
In Europe, the incidence of sarcoma is 5.6 per 100,000 people per year. For soft tissue sarcomas of any anatomic localization, the incidence is 4–5 per 100.000 persons per year [1, 2]. In certified SC, well-established interdisciplinary teams of surgical sarcoma specialists, plastic surgeons, oncologists, radiologists and radiation oncologists can provide standardized treatment pathways for these otherwise rare conditions [8–10]. The ‘Trans-Atlantic Retroperitoneal Sarcoma Working Group’ recommends treatment of retroperitoneal soft tissue sarcomas (RSTS), which often require complex multi-visceral resections, be planned and performed only in dedicated SC, where multidisciplinary sarcoma teams and tumor conferences are available [11]. Reports on the epidemiology and mortality of retroperitoneal soft tissue sarcoma (RSTS) in Switzerland are scarce. This study investigates the incidence and outcomes of surgically treated RSTS inpatients in Switzerland depending on the hospital type and size
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