Nationwide management of soft tissue sarcoma (STS) in France, before (2019) versus during COVID-19 pandemic (2020)

COVID-19 pandemic has disorganized cancer care management, with a significant decrease in diagnosed common cancer cases such as colon or breast. In France, the management of STS is organized by a network of multidisciplinary tumor boards (MTD) covering the French territory. We describe the number of incident STS cases, delay between diagnosis and 1st surgical procedure, and rate of neoadjuvant treatments in 2019 versus 2020. Eligible cases were confirmed cases of STS (diagnosed within or outside the accredited network) in adult patients; arising in limbs, girdles, superficial and internal trunk. Osseous, and visceral (e.g., GIST) were excluded. The data collected in the national database (NETSARC+) describe the activity of the 25 labelled MTD dedicated to sarcoma management. We present the data using percentages, mean and standard deviation (DS). Incident cases slightly decreased: 1,463 in 2019 versus 1,415 in 2020. Mean age, rate of male patients, tumor size, rate of Grade 1 tumors and M1 at diagnosis were similar: 62.2 (DS: 17.3) versus 63.3 (DS: 16.7); 54.8% versus 52.4%; 104 mm (DS: 79.2) versus 105.3 (DS: 77.5); 14.2% versus 14.1%; and 10.0% versus 10.5%, respectively. In 2019, 68.8% of STS were operated compared to 73.8% in 2020. The mean delay between diagnosis and surgery was 70.4 days (DS: 86.7) versus 72.2 (DS: 76.8). Surgery was performed in accredited centers in 53.5% in 2019 compared to 61.2% in 2020. Outside the network, the rate of R0 resection was 19.9% versus 27.8%. Inside accredited centers, the rate of R0 resection was 60.9 versus 69.8%. In parallel, the use of neoadjuvant treatment was 21.0% in 2019 and 26.4% in 2020. During COVID-19, we observed a slight decrease in STS incidence, while patients’ characteristics did not differ between 2019 and 2020. Both the rate of patients operated in accredited centers and R0 resections increased. There was no neoadjuvant treatment increase nor surgery delay. The accredited network therefore appears particularly robust in the event of major Health crisis.