The infl uence of national guidelines on soft tissue sarcoma patient outcome: a single center experience

Aim: The aim was to study the impact of nationwide clinical practice guidelines for soft tissue sarcomas (STS), introduced in 1994 and again in 2005 in North Savo, Finland. Methods: We retrospectively reviewed all the patients whose sarcoma was treated by a multidisciplinary team between the years 2000 and 2009 with mean follow-up time of 68 months. The patients were divided into 2 groups according to years: Group A (2000–2005, 72 patients) and Group B (2006–2009, 64 patients). Primary outcomes were local recurrence, metastases, and overall survival. Results: Fifty-fi ve percent were men with an average age of 59 years. The most common sarcomas were pleomorphic sarcoma (37%) and liposarcoma (26%). Although there were signifi cantly less amputations in Group B (A: 15%, B: 3%), there were more metastases (A: 10%, B: 23%) with an overall lower overall survival rate (A: 70%, B: 58%) than in Group A. Conversely, Group A had a higher 1st year survival rate (A: 100%, B: 87%). We found that upper limb sarcomas were more likely to be diagnosed with incisional biopsies, but there was no correlation between incisional biopsy and recurrence, metastases or survival. Conclusion: Due to nonadherence of the 2005 national treatment recommendations, there has been no improvement either in management or survival. The importance of educating guidelines to doctors referring patients to specialized units cannot be overemphasized to affect successful management in the treatment of STS.