National Comprehensive Cancer Network guidelines compliance of a sarcoma service:A retrospective review

BACKGROUND Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network(NCCN)to ensure patients are treated uniformly and appropriately.This study sought to retrospectively review patients with a new diagnosis of sarcoma who were treated in a National Cancer Institute(NCI)designated center and determine compliance rates with guidelines for sarcoma.AIM To evaluate our compliance of NCCN sarcoma guidelines at a major NCI designated center and to report instances of deviation that could be used for future studies to improve patient care.METHODS Data was collected retrospectively as an internal review and quality assessment of 35 newly diagnosed and treated patients.Demographic data were recorded and information concerning whether patients had appropriate imaging,biopsy and management.Variables of interest were expressed as raw numbers and percentages.RESULTS Primary site imaging was obtained in 100%of cases.Chest and full-body imaging were obtained in 97%and 100%of indicated cases,respectively.Tissue was obtained preoperatively in 97%of cases.Imaging was reviewed at multidisciplinary Treatment Planning Conference(TPC)in 97%of cases.Pathology was reviewed in 94%of cases in TPC.Both tumor,node,metastasis staging and plan of care were reviewed in 100%of cases in TPC.Treatment guidelines were followed in 94%of cases reviewed.CONCLUSION This study evaluated the workup and treatment provided by a single NCI designated sarcoma service to a series of patients with pathologies defined with the NCCN sarcoma treatment guidelines.Although adherence to NCCN was reported to be very high future prospective studies are required to investigate whether NCCN guidelines impact patient outcomes.

National Comprehensive Cancer Network （NCCN） riSK classification in predicting biochemical recurrence after radical prostatectomy： a retrospective cohort study in Chinese prostate cancer patients

This study aimed to assess the role of the National Comprehensive Cancer Network （NCCN） risk classification in predicting biochemical recurrence （BCR） after radical prostatectomy （RP） in Chinese prostate cancer patients. We included a consecutive cohort of 385 patients with prostate cancer who underwent RP at Fudan University Shanghai Cancer Center （Shanghai, China） from March 2011 to December 2014. Gleason grade groups were applied at analysis according to the 2014 International Society of Urological Pathology Consensus. Risk groups were stratified according to the NCCN Clinical Practice Guidelines in Oncology： Prostate Cancer version 1, 2017. All 385 patients were divided into BCR and non-BCR groups. The clinicopathological characteristics were compared using an independent sample t-test, Chi-squared test, and Fisher＇s exact test. BCR-free survival was compared using the log-rank test and multivariable Cox proportional hazard analysis. During median follow-up of 48 months （range： 1-78 months）, 31 （8.05%） patients experienced BCR. The BCR group had higher prostate-specific antigen level at diagnosis （46.54 ± 39.58 ng m1-1 vs 21.02 ± 21.06 ng ml-1, P= 0.001）, more advanced pT stage （P= 0.002）, and higher pN1 rate （P〈 0.001）. NCCN risk classification was a significant predictor of BCR {P = 0.0006） and BCR-free survival （P = 0.003） after RP. As NCCN risk level increased, there was a significant decreasing trend in BCR-free survival rate （Ptrend = 0.0002）. This study confirmed and validated that NCCN risk classification was a significant predictor of BCR and BCR-free survival after RP.

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

The spread of the new coronavirus(COVID-19)infection in 2020 has had a significant impact on the treatment of cancer worldwide.During the COVID-19 pandemic,the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care.In this review article,from the standpoint of surgeons,we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic,and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors.The most vital points in selecting the best therapeutic approach for patients with pancreatic tumors during this pandemic are(1)Oncologists need to tailor the treatment plan based on the COVID-19 phase,tumor malignant potential,and patients’comorbidities;and(2)Optimal treatment for pancreatic cancer should be planned according to the condition of each patient and tumor resectability based on national comprehensive cancer network resectability criteria.To choose the best therapeutic approach for patients with pancreatic tumors during this pandemic,we need to tailor the treatment plan based on elective surgery acuity scale(ESAS).Newly established ESAS for pancreatic tumor and flowchart indicating the treatment strategy of pancreatic cancer,are feasible to overcome this situation.

Review of practice informing data and current state of NCCN consensus guidelines in hepatobiliary cancers

The most important recent updates to the US National Comprehensive Cancer Network(NCCN)guidelines include the addition of new immunotherapy agents to the armamentarium for both hepatocellular carcinoma(HCC)and biliary tract cancers(1).The publication and subsequent the US Food and Drug Administration(FDA)approval of the Single Tremelimumab Regular Interval Durvalumab(STRIDE)regimen established in the phase III HIMALAYA trial(2)adds an important option for first-line systemic treatment of advanced HCC and was included in the NCCN guidelines with the 4.