Improving Long-Term Outcomes for Patients with Extra-Abdominal Soft Tissue Sarcoma Regionalization to High-Volume Centers, Improved Compliance with Guidelines or Both?
Table 2
Bivariate associations between volume tercile and patient characteristics.
1st tercile ()
2nd tercile ()
3rd tercile ()
Total ()
value
Number of hospitals
934
180
44
1158
Annual number of surgeries
≤3
3.2–< 11
≥11
Mean annual number of surgeries (range)
2 (1–3)
6 (3–11)
28 (11–81)
30-day mortality
55 (1.2%)
41 (0.9%)
19 (0.4%)
115 (0.9%)
<0.001
Overall mortality
1676 (35.8%)
1524 (34.2%)
1473 (32.4%)
4673 (34.1%)
0.003
Compliance
1272 (49.8%)
1345 (50.9%)
1582 (53.3%)
4199 (51.5%)
0.03
Age (years)
<0.001
Mean (SD)
58.4 (18.3)
55.2 (17.6)
54.2 (17.7)
56.0 (18.0)
Median
59
55
55
56
Sex
0.12
Male
2444 (52.2%)
2335 (52.4%)
2461 (54.1%)
7240 (52.9%)
Race
<0.001
Missing
44
95
56
249
White
3040 (85.8%)
3011 (81.4%)
2831 (80.8%)
12057 (83.8%)
Black
372 (10.5%)
547 (14.8%)
475 (13.6%)
1758 (12.2%)
Others
131 (3.7%)
141 (3.8%)
199 (5.7%)
570 (4.0%)
Insurance
<0.001
Missing
99
156
186
441
No
205 (4.5%)
256 (6.0%)
167 (3.8%)
628 (4.7%)
Yes
4378 (95.5%)
4045 (94.0%)
4192 (96.2%)
12615 (95.3%)
Income†
<0.001
Missing
215
228
227
670
<$30,000
570 (12.8%)
640 (15.1%)
506 (11.7%)
1716 (13.2%)
$30,000–$34,999
768 (17.2%)
730 (17.3%)
776 (18.0%)
2274 (17.5%)
$35,000–$45,999
1282 (28.7%)
1072 (25.3%)
1241 (28.7%)
3595 (27.6%)
$46,000+
1847 (41.3%)
1787 (42.3%)
1795 (41.6%)
5429 (41.7%)
Education
<0.001
Missing
215
228
227
670
1: 29%+
763 (17.1%)
814 (19.2%)
638 (14.8%)
2215 (17.0%)
2: 20%–28.9%
978 (21.9%)
955 (22.6%)
943 (21.8%)
2876 (22.1%)
3: 14%–19.9%
1100 (24.6%)
869 (20.5%)
1026 (23.8%)
2995 (23.0%)
4: <14%
1626 (36.4%)
1591 (37.6%)
1711 (39.6%)
4928 (37.9%)
Facility type
<0.001
Community cancer program
919 (19.6%)
22 (0.5%)
0 (0.0%)
941 (6.9%)
Comprehensive community cancer program
3018 (64.5%)
1730 (38.8%)
575 (12.7%)
5323 (38.9%)
Academic/research program
744 (15.9%)
2705 (60.7%)
3970 (87.3%)
7419 (54.2%)
Other specified types of cancer programs
1 (0.0%)
0 (0.0%)
0 (0.0%)
1 (0.0%)
Charlson/Deyo score
0.004
0
3949 (84.3%)
3762 (84.4%)
3929 (86.4%)
11640 (85.1%)
1
580 (12.4%)
581 (13.0%)
507 (11.2%)
1668 (12.2%)
2+
153 (3.3%)
114 (2.6%)
109 (2.4%)
376 (2.7%)
Primary site
<0.001
Extremity
1964 (41.9%)
2318 (52.0%)
3091 (68.0%)
7373 (53.9%)
Trunk
2053 (43.8%)
1619 (36.3%)
1083 (23.8%)
4755 (34.7%)
Head/neck
428 (9.1%)
342 (7.7%)
251 (5.5%)
1021 (7.5%)
Overlapping
237 (5.1%)
178 (4.0%)
120 (2.6%)
535 (3.9%)
Histology
<0.001
Liposarcoma
750 (16.0%)
830 (18.6%)
929 (20.4%)
2509 (18.3%)
Fibrosarcoma
288 (6.2%)
308 (6.9%)
374 (8.2%)
970 (7.1%)
Leiomyosarcoma
795 (17.0%)
642 (14.4%)
544 (12.0%)
1981 (14.5%)
MFH
1051 (22.4%)
794 (17.8%)
690 (15.2%)
2535 (18.5%)
Myxofibroma
26 (0.6%)
27 (0.6%)
35 (0.8%)
88 (0.6%)
MPNST
156 (3.3%)
175 (3.9%)
221 (4.9%)
552 (4.0%)
NOS
1616 (34.5%)
1681 (37.7%)
1752 (38.5%)
5049 (36.9%)
Stage
<0.001
Missing
1757
1558
1357
4672
Stage I
1571 (53.7%)
1333 (46.0%)
1297 (40.7%)
4201 (46.6%)
Stage II
716 (24.5%)
687 (23.7%)
764 (24.0%)
2167 (24.0%)
Stage III
638 (21.8%)
879 (30.3%)
1127 (35.4%)
2644 (29.3%)
Grade
<0.001
Well differentiated
985 (21.0%)
903 (20.3%)
979 (21.5%)
2867 (21.0%)
Moderately differentiated
559 (11.9%)
567 (12.7%)
544 (12.0%)
1670 (12.2%)
Poorly differentiated
986 (21.1%)
1066 (23.9%)
1203 (26.5%)
3255 (23.8%)
Undifferentiated
539 (11.5%)
629 (14.1%)
974 (21.4%)
2142 (15.7%)
Cell type not determined
1613 (34.5%)
1292 (29.0%)
845 (18.6%)
3750 (27.4%)
Tumor size
<0.001
Missing
853
740
613
2206
<5 cm
1766 (46.1%)
1339 (36.0%)
1317 (33.5%)
4422 (38.5%)
5–10 cm
1149 (30.0%)
1183 (31.8%)
1250 (31.8%)
3582 (31.2%)
>10 cm
914 (23.9%)
1195 (32.1%)
1365 (34.7%)
3474 (30.3%)
Surgical margins
<0.001
Missing
982
743
544
2269
0: Negative
3071 (83.0%)
3205 (86.3%)
3606 (90.1%)
9882 (86.6%)
1: Microscopically positive
526 (14.2%)
428 (11.5%)
359 (9.0%)
1313 (11.5%)
2: Grossly positive
103 (2.8%)
81 (2.2%)
36 (0.9%)
220 (1.9%)
Surgical margins (amputation cases excluded)
<0.001
Missing
971
735
532
2238
Negative (R0)
3015 (82.8%)
3078 (85.9%)
3378 (89.6%)
9471 (86.1%)
Microscopically positive (R1)
523 (14.4%)
424 (11.8%)
357 (9.5%)
1304 (11.9%)
Grossly positive (R2)
103 (2.8%)
81 (2.3%)
36 (1.0%)
220 (2.0%)
Chemotherapy
<0.001
Missing
180
119
73
372
No
4039 (89.7%)
3713 (85.6%)
3589 (80.3%)
11341 (85.2%)
Yes
463 (10.3%)
625 (14.4%)
883 (19.7%)
1971 (14.8%)
Radiation
<0.001
Missing
113
85
46
244
No
3173 (69.4%)
2813 (64.3%)
2612 (58.1%)
8598 (64.0%)
Yes
1396 (30.6%)
1559 (35.7%)
1887 (41.9%)
4842 (36.0%)
Extremity STS only
()
()
()
()
Amputation rate
70 (3.6%)
139 (6.0%)
242 (7.8%)
451 (6.1%)
<0.001
†Median household income for each patient’s area of residence as estimated by matching the zip code of the patient recorded at the time of diagnosis against files derived from year 2000 US Census data; ‡measure of the number of adults in the patient’s zip code who did not graduate from high school as estimated by matching the zip code of the patient recorded at the time of diagnosis against files derived from year 2000 US Census data; MFH, malignant fibrous histiocytoma; MPNST, malignant peripheral nerve sheath tumor; NOS, not otherwise specified.
