Data Dissemination of the Role of Neoadjuvant Radiation in Retroperitoneal Sarcoma: A CTOS and CSSO Survey.
Sarah CornCarolyn NessimChristina Lynn RolandAlessandro GronchiCarolyn FreemanSinziana DumitraPublished in: Current oncology (Toronto, Ont.) (2023)
Consensus guidelines call for complete resection of retroperitoneal sarcoma with consideration of neoadjuvant radiation for curative-intent treatment. The 15-month delay from the initial presentation of an abstract to the final publication of the STRASS trial results assessing the impact of neoadjuvant radiation led to a dilemma of how patients should be managed in the interim. This study aims to (1) understand perspectives regarding neoadjuvant radiation for RPS during this period; and (2) assess the process of integrating data into practice. A survey was distributed to international organizations including all specialties treating RPS. Eighty clinicians responded, including surgical (60.5%), radiation (21.0%) and medical oncologists (18.5%). Low kappa correlation coefficients on a series of clinical scenarios querying individual recommendations before and after initial presentation as an abstract indicate considerable change. Over 62% of respondents identified a practice change; however, most also noted discomfort in adopting changes without a manuscript available. Of the 45 respondents indicating discomfort with practice changes without a full manuscript, 28 (62%) indicated that their practice changed in response to the abstract. There was substantial variability in recommendations for neoadjuvant radiation between the presentation of the abstract and the publication of trial results. The difference in the proportion of clinicians describing comfort with changing practice based on the presentation of the abstract versus those that had done so shows that indications for proper integration of data into practice are not clear. Endeavors to resolve this ambiguity and expedite availability of practice-changing data are warranted.
Keyphrases
- rectal cancer
- healthcare
- primary care
- locally advanced
- lymph node
- electronic health record
- quality improvement
- big data
- clinical practice
- case report
- palliative care
- end stage renal disease
- squamous cell carcinoma
- randomized controlled trial
- radiation therapy
- phase ii
- climate change
- cross sectional
- deep learning
- robot assisted
- prognostic factors
- patient reported outcomes
- advanced cancer
- inflammatory response
- minimally invasive
- nuclear factor