1 Épidémiologie des sarcomes en Belgique Dr. Liesbet Van Eycken 12 es journées annuelles du GSF-GETO Oud Sint-Jan Bruges, 22-24 juin 2016
Overview Introduction Descriptive epidemiology Incidence Age specific incidence TNM stage Survival Rarecarenet: HR study: soft tissue sarcoma, results for Belgium (extremities) Conclusion 2
Belgium 2013: 65.487 new cancer cases pithelial malignancies (80%) Haematological malignancies (9%) Malignant tumour, NOS (3%) Malignant tumours of brain and nervous system (1%) Other specified malignancies (germ cell tumours, malignant melanoma,...) (5%) Sarcoma 2% of all Malignant tumours ~1300/year * All malignant tumours (non-melanoma skin cancer included) 3
All Soft Tissue Sarcoma Incidence, 2004-2013 4
Belgium 2013, WHO classification of Tumours of Soft Tissue and Bone, 2013 99 99 77 26 47 241615 289 136 Stromal tumours (24.2%) Fibroblastic / Myofibroblastic tumours (11.4%) Myomatous neoplasms (10.8%) Mixed epithelial mesenchymal tumours (10.0%) Bone tumours (9.7%) Adipocytic tumours (8.3%) Undifferentiated/Unclassified sarcoma (8.3%) Vascular tumours (6.5%) Other specified sarcoma (3.9%) Nerve Sheath tumours (2.2%) Synovial neoplasms (2.0%) Phyllodes tumours (1.3%) Sarcoma of uncertain differentiation (1.3%) 116 119 129 5
Fibroblastic /myofibroblastic tumours Belgium 2004-2013: N = 1,159 Fibrosarcoma Dermatofibrosarcoma Fibromyxosarcoma Solitary fibrous tumour Myofibroblastic tumour 6
Fibroblastic / myofibroblastic tumours Belgium 2004-2013: N = 1,159 1,4 Age specific incidence (N/100.000) 1,1 0,7 0,4 0,0 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75- 80-85+ Age category Fibrosarcoma Fibromyxosarcoma Dermatofibrosarcoma 7
Myomatous sarcoma Belgium 2004-2013: N = 1,530 5,0 Age specific incidence (N/100,000) 3,8 2,5 1,3 0,0 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75- 80-85+ Age category Leiomyosarcoma Rhabdomyosarcoma 8
Bone tumours, Belgium 2004-2013: N = 1,198 1,2 Age specific incidence (N/100.000) 0,9 0,6 0,3 0,0 0-5- 10-15- 20-25- 30-35- 40-45- 50-55- 60-65- 70-75- 80-85+ Age category Osteosarcoma Chondrosarcoma Chordoma Ewing Sarcoma 9
Bone tumours, Belgium 2004-2013: N = 1,198 100 % 75 % 50 % 25 % 0 % Upper limb (N = 134) Skull (N = 78) Ribs, sternum and clavicle (N = 91) Bone, NOS (N = 153) Osteosarcoma (N = 340) Chondrosarcoma (N = 432) Chordoma (N = 74) Ewing sarcoma (N = 240) 10
Liposarcoma, Belgium 2004-2013: N = 1,024 Mixed type LS Myxoid LS or Round cell LS Liposarcoma (LS), NOS Dedifferentiated LS Pleomorphic LS Myxoid LS or round cell LS Well diferentiated LS 11
Liposarcoma, Belgium 2004-2013: N = 1,024 1,2 Age specific incidence in both sexes by histology, 1000 2004-2013 0,9 N/100,000 0,6 0,3 0,0 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ Age category Well diferentiated LS Myxoid LS Pleomorphic LS Dedifferentiated LS 12
Sarcoma subtypes, Belgium 2004-2013 TNM stage: known unknown not applicable rtilage tumours Sheath tumours r bone tumours ssified sarcoma muscle tumours differentiation novial neoplasm chymal tumours muscle tumours pocytic tumours ogenic tumours blastic tumours stromal tumour ascular tumours 0 % 25 % 50 % 75 % 100 % Stage known Stage unknown Unstageable 13
Sarcoma subtypes, Belgium 2004-2013 Stage I Stage II Stage III Stage IV 100 % 75 % 50 % 25 % 14 0 % All sarcoma Sarcoma of uncertain differentiation Adipocytic tumours Cartilage tumours
Sarcoma subtypes, 5-year relative survival, Belgium 2004-2013 stromal tumour ofibroblastic tumours Adipocytic tumours Bone tumours esenchymal tumours Vascular tumours Nerve Sheath tumours ertain differentiation Myomatous neoplasms Synovial neoplasm /Unclassified sarcoma 0 % 25 % 50 % 75 % 100 % Male Female 15
Liposarcoma, Belgium 2004-2013: N = 1,024 100 % % Relative survival 75 % 50 % 25 % Well diferentiated LS Myxoid LS Mixed type LS Liposarcoma (LS), NOS Dedifferentiated LS Pleomorphic LS 0 % 0 1 2 3 4 5 Years after diagnosis 16
A cancer registry is a basic tool for cancer surveillance a. To serve public health by monitoring changes in cancer occurrence and prognosis (epidemiology) and evaluating mass interventions like screening descriptive epidemiology: incidence, survival and prevalence. b. To serve oncology by studying access and variation in quality of care and outcomes, including the patient perspective, and cause-specific mortality. The methods of quality of care research also include interpretation of context and regular feedback to the clinicians involved. Eurocourse FP7, JW Coebergh et al. 2012 17
Rarecarenet, soft tissue sarcoma (extremities) Tumours diagnosed in 2009-2010, Belgium High resolution study on Soft tissue sarcoma (limbs), n=280 Extended dataset: manual registration and merging of available data Quality Indicators 1. Diagnostic management, biopsy 2. 2 nd opinion pathology (expert) 3. Resection margins 4. Reoperation 18
Soft tissue sarcoma: Diagnostic management, histological verification N cases biopsy surgery without biopsy Belgium 280 41% 59% T Freq. % T1 51 31.1 T1A 13 7.9 T1B 9 5.5 T2 44 26.8 T2A 9 5.5 T2B 15 9.2 missing or X 23 14.0 Total 164 100
Soft tissue sarcoma: volume and resection margins
Soft tissue sarcoma: re-operation (22%)
Thank you for your attention Thank you Kris Henau 22
All sarcoma Males Females Incidence 2013 (N) 560 632 Prevalence (5y) 1,912 2,208 Prevalence (10y) 3,218 3,825 Relative survival (5y) 67.6% 63.4% Relative survival (10y) 62.2% 57.2% 23