Background: Soft-tissue sarcomas (STSs) are rare and challenging to diagnose due to their heterogeneous presentation. In 2009, Denmark introduced the Cancer Patient Pathways for sarcomas (CPPs) to improve sarcoma treatment by streamlining diagnostic and therapeutic processes. The primary objective of this study is to evaluate the impact of the CPPs on the overall survival of patients with deep-seated, high-grade STSs, comparing outcomes from before and after CPP implementation. Methods: A retrospective cohort study was conducted using data from 712 patients diagnosed with high-grade STSs in the extremities or trunk wall between 2000 and 2018. Patients were grouped into pre-CPP (2000–2008) and post-CPP (2010–2018) cohorts. Overall survival was analyzed using Kaplan–Meier estimates. Results: The five-year overall survival improved from 43% in the pre-CPP cohort to 52% post-CPP (p= 0.05). Time-to-treatment was significantly reduced in the post-CPP cohort, with a median decrease of 3 days (18 vs. 15 days,p< 0.001). We found only a very weak tendency toward larger tumor sizes in the pre-CPP cohort and no difference regarding the percentage of patients that had distant metastases at diagnosis between cohorts. In the post-CPP cohort, the percentage of whoops operations decreased and the use of oncological services increased. Conclusions: After the introduction of the CPPs for the sarcoma patients, overall survival improved and time to treatment was reduced. This study highlights the importance of efficient referral pathways in improving cancer outcomes but cannot exclude that other factors could also have contributed.
背景：软组织肉瘤（STSs）因其临床表现异质性而罕见且诊断困难。2009年，丹麦引入了肉瘤癌症患者路径（CPPs），通过优化诊疗流程以改善肉瘤治疗效果。本研究主要目的是评估CPPs对深部高级别STSs患者总生存期的影响，比较CPPs实施前后的治疗结果。方法：本研究采用回顾性队列分析，纳入2000年至2018年间诊断为四肢或躯干壁高级别STSs的712例患者数据。将患者分为CPP实施前（2000-2008年）与实施后（2010-2018年）队列，采用Kaplan-Meier法评估总生存期。结果：五年总生存率从CPP实施前的43%提升至实施后的52%（p=0.05）。实施后队列的治疗启动时间显著缩短，中位时间减少3天（18天 vs. 15天，p<0.001）。研究发现CPP实施前队列仅呈现肿瘤体积略大的微弱趋势，两组间初诊时远处转移患者比例无显著差异。在CPP实施后队列中，意外手术比例下降，肿瘤专科服务使用率增加。结论：肉瘤患者CPPs实施后，患者总生存期得到改善，治疗启动时间缩短。本研究凸显了高效转诊路径对改善癌症预后的重要性，但尚不能排除其他影响因素的作用。
肿瘤(癌症)患者之家