Surgery in reference centers improves survival of sarcoma patients: a nationwide study

International audienceBackgroundNETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry.Patients and methodsPatients’ characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497).ResultsAmong the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li–Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P < 0.001 for all, with a hazard ratio of 0.681 (95% CI 0.618–0.749) for OS].ConclusionThis nationwide registry of sarcoma patients shows that surgical treatment in a reference center reduces the risk of relapse and death

Composition dependent physical properties of poly[(vinylidene fluoride)-co-trifluoroethylene] - poly(ethylene oxide) blends

Polymer blends based on poly(vinylidene fluoride – co – trifluoroethylene) copolymers, P(VDF-TrFE), and poly(ethylene oxide), PEO, with varying compositions have been prepared by solvent casting. In this way, P(VDF-TrFE) crystallizes from the solution while solvent evaporates, while PEO crystallizes from the melt during cooling to room temperature. The surface morphology of the polymer blends indicates the transition from the fibrillar microstructure typical of PVDF-TrFE to the spherulite structure characteristic of PEO. The vibration modes characteristics of P(VDF-TrFE) are not influenced by the presence of PEO in the polymer blend. Confinement of PEO in the P(VDF-TrFE) phase change the conformation of PEO from trans to helix, increasing this transformation for increasing P(VDF-TrFE) content in the polymer blends. Sequential crystallization of the two polymers produce separated amorphous phases whose independent cooperative conformational motions are revealed by two main dynamic-mechanical relaxations. No chemical interaction seems to exist between the polymers within the blend.Abstract: Polymer blends based on poly(vinylidene fluoride – co – trifluoroethylene) copolymers, P(VDF-TrFE), and poly(ethylene oxide), PEO, with varying compositions have been prepared by solvent casting. In this way, P(VDF-TrFE) crystallizes from the solution while solvent evaporates, while PEO crystallizes from the melt during cooling to room temperature. The surface morphology of the polymer blends indicates the transition from the fibrillar microstructure typical of PVDF-TrFE to the spherulite structure characteristic of PEO. The vibration modes characteristics of P(VDF-TrFE) are not influenced by the presence of PEO in the polymer blend. Confinement of PEO in the P(VDF-TrFE) phase change the conformation of PEO from trans to helix, increasing this transformation for increasing P(VDF-TrFE) content in the polymer blends. Sequential crystallization of the two polymers produce separated amorphous phases whose independent cooperative conformational motions are revealed by two main dynamic-mechanical relaxations. No chemical interaction seems to exist between the polymers within the blend