No Geographical Inequalities in Survival for Sarcoma Patients in France: A Reference Networks' Outcome? - Centre Oscar Lambret Accéder directement au contenu
Article Dans Une Revue Cancers Année : 2022

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

1 Centre Léon Bérard [Lyon]
2 RESHAPE - Inserm U1290 - UCBL1 - Research on Healthcare Performance
3 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
4 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
5 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
6 IGR - Institut Gustave Roussy
7 Département de médecine oncologique [Gustave Roussy]
8 Institut Bergonié [Bordeaux]
9 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
10 Institut Curie [Paris]
11 CHU Trousseau [Tours]
12 UT - Université de Tours
13 CRCT - Centre de Recherches en Cancérologie de Toulouse
14 Institut Claudius Regaud
15 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
16 IPC - Institut Paoli-Calmettes
17 CHU Sud Saint Pierre [Ile de la Réunion]
18 Hôpital Dupuytren [CHU Limoges]
19 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
20 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
21 CHU Pitié-Salpêtrière [AP-HP]
22 IUC - Institut Universitaire de Cancérologie [Sorbonne Université]
23 Galilée - Galilée
24 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
25 AP-HP - Hopital Saint-Louis [AP-HP]
26 Hôpital Cochin [AP-HP]
27 Cancer Research and Personalized Medicine - CARPEM [Paris]
28 IC UM3 (UMR 8104 / U1016) - Institut Cochin
29 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
30 UR - Université de Rennes
31 Hôpital privé de la Loire
32 Hôpital Charles Nicolle [Rouen]
33 ICANS - Institut de Cancérologie de Strasbourg Europe
34 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
35 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
36 Hôpital universitaire Robert Debré [Reims]
37 AMU - Aix Marseille Université
38 TIMONE - Hôpital de la Timone [CHU - APHM]
39 CHU Lyon
40 ICM - Institut régional de Cancérologie de Montpellier
41 Pôle chirurgical et interventionnel [Gustave Roussy]
42 PSL - Université Paris sciences et lettres
Cécile Dalban
  • Fonction : Auteur
  • PersonId : 937630
Pierre Méeus
  • Fonction : Auteur
  • PersonId : 940187
François Le Loarer
  • Fonction : Auteur
  • PersonId : 1083880
Daniel Orbach
  • Fonction : Auteur
  • PersonId : 1104965
François Bertucci
Valérie Le Brun-Ly
  • Fonction : Auteur
  • PersonId : 1004835
Sylvie Chabaud
  • Fonction : Auteur
  • PersonId : 940706
Françoise Ducimetière
  • Fonction : Auteur
  • PersonId : 918956
Paul Michelin
  • Fonction : Auteur
  • PersonId : 1063768
Marie Karanian
  • Fonction : Auteur
  • PersonId : 1077684
Jean-Michel Coindre
  • Fonction : Auteur
  • PersonId : 855612
Isabelle Ray-Coquard
  • Fonction : Auteur
  • PersonId : 1077679
Jean-Yves Blay

Résumé

Simple Summary As patients with rare cancers face specific problems, reference networks have been developed in several European countries and then at the European level to improve their management. In some cases, the specialized centers belonging to reference networks provide remote services (specialized diagnosis review, discussion in the Multidisciplinary Tumour Board, etc.) to increase access to these services. Using data from the national sarcoma reference network implemented in France (NETSARC+), the IGeAS research program assesses the potential of its organization to address the geographical inequalities in cancer management. We analyze the individual, clinical, and geographical determinants of the overall survival of sarcoma patients in France. We found no association between the overall survival of sarcoma patients and variables measuring their social deprivation, remoteness from reference centers, and geographical context. Following previous results from the research program, this study suggests that reference network organization should be considered to reduce cancer inequalities. 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 IGeAS research program aims to assess the potential of this innovative organization to address geographical inequalities in cancer management. Using the IGeAS 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.

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Cancer
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hal-03718397 , version 1 (08-07-2022)

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Yohan Fayet, Christine Chevreau, Gauthier Decanter, Cécile Dalban, Pierre Méeus, et al.. No Geographical Inequalities in Survival for Sarcoma Patients in France: A Reference Networks' Outcome?. Cancers, 2022, 14 (11), pp.2620. ⟨10.3390/cancers14112620⟩. ⟨hal-03718397⟩
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