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Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on...
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Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Informatics and Big Data".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 15246

Special Issue Editor

Prof. Dr. Bruno Fuchs

E-Mail Website
Guest Editor
Sarcoma Service & IPU, Faculty of Health Science & Medicine, University of Lucerne, CH-6004 Luzern, Switzerland
Interests: sarcoma surgery; sarcoma MDT; quality indicators; VBHC
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sarcomas belong to the rare diseases, there are some 150 molecularly defined biological subtypes, and its treatment is highly complex and transdisciplinary. The development of novel therapies has been stagnating over years for numerous complex reasons. Although it is accepted that only the interplay of several disciplines may render successful treatment results in sarcoma patients, data are usually still mono-disciplinarily reported, and there is no global approach for longitudinal prospective acquisition of structured data on quality. The successful introduction of the “Sarculator” and “PerSarc” -though still imperfect tools- has demonstrated the urge how clinicians starve for outcome prediction tools to incorporate into their strategic treatment decisions. Whereas real-time outcome prediction for sarcoma patients is the defined goal, we have to define the approach how to get there on a global level considering all possible aspects.

A first step includes the establishment of  an overview what is available to then possibly orchestrate on the global level, and to outline the opportunities.

Herewith, we aim for a current global representation of sarcoma registries available within the existing sarcoma networks with detailed overview how they work. Further, we want to consider the novel opportunities of digital transformation and challenges of international data exchange and analytics.

Prof. Dr. Bruno Fuchs
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sarcoma
  • registry/data bases
  • data harmonization and exchange
  • global collaboration
  • digital transformation
  • predictive outcome analytics
  • prognosis & prognostic research
  • prognostic and predictive models
  • predictive analytics & machine learning

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Published Papers (6 papers)

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Research

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15 pages, 1364 KiB  
Article
Benchmarking Time-to-Treatment Initiation in Sarcoma Care Using Real-World-Time Data
by Markus Schärer, Philip Heesen, Beata Bode-Lesniewska, Gabriela Studer and Bruno Fuchs
Cancers 2023, 15(24), 5849; https://doi.org/10.3390/cancers15245849 - 15 Dec 2023
Cited by 7 | Viewed by 1635
Abstract
Benchmarking is a fundamental tool for enhancing quality within a patient-centered healthcare framework. This study presents an analysis of time-to-treatment initiation (TTI) for sarcoma patients, utilizing a database encompassing 266 cases from the Swiss Sarcoma Network. Our findings indicate a median TTI of [...] Read more.
Benchmarking is a fundamental tool for enhancing quality within a patient-centered healthcare framework. This study presents an analysis of time-to-treatment initiation (TTI) for sarcoma patients, utilizing a database encompassing 266 cases from the Swiss Sarcoma Network. Our findings indicate a median TTI of 30 days across the cohort, with bone sarcomas and deep soft tissue sarcomas demonstrating a shorter median TTI of 28 days, followed by superficial soft tissue sarcomas at 42 days. The data reveal that the use of real-world-time data (RWTD) may account for a longer TTI observed, as it offers more comprehensive capture of patient journeys, unlike conventional datasets. Notably, variability in TTI was observed between different treatment institutions, which underscores the need for standardized processes across centers. We advocate for a selective referral system to specialized centers to prevent capacity overload and ensure timely treatment initiation. Our analysis also identified significant delays in TTI for unplanned ‘whoops’-resections, highlighting the importance of early specialist referral in optimizing treatment timelines. This study emphasizes the potential benefits of a streamlined, data-informed approach to sarcoma care. However, further research is required to establish the direct impact of integrated care models on TTI and patient outcomes in the context of sarcoma treatment. Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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21 pages, 2132 KiB  
Article
Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis
by Maria Elyes, Philip Heesen, Georg Schelling, Beata Bode-Lesniewska, Gabriela Studer and Bruno Fuchs
Cancers 2023, 15(19), 4892; https://doi.org/10.3390/cancers15194892 - 9 Oct 2023
Cited by 6 | Viewed by 1598
Abstract
Sarcomas, rare and with lower survival rates than common tumors, offer insights into healthcare efficiency via the analysis of the total interval of the diagnostic pathway, combining the patient interval (time between the first symptom and visit with a physician) and diagnostic interval [...] Read more.
Sarcomas, rare and with lower survival rates than common tumors, offer insights into healthcare efficiency via the analysis of the total interval of the diagnostic pathway, combining the patient interval (time between the first symptom and visit with a physician) and diagnostic interval (time between first physician visit and histological diagnosis). Switzerland’s healthcare system, Europe’s costliest, lacks research on treating rare conditions, like mesenchymal tumors. This study examines the total interval of the diagnostic pathway for optimization strategies. Analyzing a dataset of 1028 patients presented from 2018 to 2021 to the Swiss Sarcoma Board (MDT/SB-SSN), this retrospective analysis delves into bone sarcoma (BS), soft-tissue sarcoma (STS), and their benign counterparts. Demographic and treatment data were extracted from medical records. The patient interval accounted for the largest proportion of the total interval and secondary care interval for the largest proportion of the diagnostic interval. Age, grade, and localization could be elicited as influencing factors of the length of different components of the total interval. An increasing age and tumor size, as well as the axial localization, could be elicited as factors increasing the probability of sarcoma. The patient and secondary care interval (SCI) offer the greatest potential for optimization, with SCI being the bottleneck of the diagnostic interval. New organizational structures for care work-ups are needed, such as integrated practice units (IPU) as integral part of value-based healthcare (VBHC). Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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17 pages, 3895 KiB  
Article
Unlocking the Power of Benchmarking: Real-World-Time Data Analysis for Enhanced Sarcoma Patient Outcomes
by Bruno Fuchs, Georg Schelling, Maria Elyes, Gabriela Studer, Beata Bode-Lesniewska, Mario F. Scaglioni, Pietro Giovanoli, Philip Heesen and on behalf of the SwissSarcomaNetwork
Cancers 2023, 15(17), 4395; https://doi.org/10.3390/cancers15174395 - 2 Sep 2023
Cited by 15 | Viewed by 3148
Abstract
Benchmarking is crucial for healthcare providers to enhance quality and efficiency, notably for complex conditions like sarcomas. Multidisciplinary teams/sarcoma boards (MDT/SBs) are vital in sarcoma management, but differences in their processes can affect patient outcomes and treatment costs, despite adherence to international guidelines. [...] Read more.
Benchmarking is crucial for healthcare providers to enhance quality and efficiency, notably for complex conditions like sarcomas. Multidisciplinary teams/sarcoma boards (MDT/SBs) are vital in sarcoma management, but differences in their processes can affect patient outcomes and treatment costs, despite adherence to international guidelines. To address this issue, this study aimed to compare two MDT/SBs and establish an interoperable digital platform, Sarconnector®, for real-time-world data assessment and automated analysis. The study included 983 patients, 46.0% of whom female, with a median age of 58 years, and 4.5% of patients presented with metastasis at diagnosis. Differences were observed in the number of first-time presentations, follow-up presentations, primary sarcomas, biopsies and chemotherapy indications between the two MDT/SB. The results highlight the importance of benchmarking and utilizing a harmonized data approach, such as the RWT approach provided by the Sarconnector®, to standardize and evaluate quality and cost metrics. By identifying areas of improvement and making data-driven decisions on the meta-level, healthcare providers can optimize resources and improve patient outcomes. In conclusion, benchmarking with the RWT harmonized data approach provided by the Sarconnector® can help healthcare providers improve the overall effectiveness of the healthcare system and achieve better outcomes for their patients in terms of both outcomes and costs. Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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11 pages, 1972 KiB  
Article
How Is the Spectrum of Sarcoma Surgery Assessed?
by Carlo Theus-Steinmann, Georg Schelling, Philip Heesen, Stefan Breitenstein, Mario F. Scaglioni and Bruno Fuchs
Cancers 2023, 15(4), 1305; https://doi.org/10.3390/cancers15041305 - 18 Feb 2023
Cited by 3 | Viewed by 1873
Abstract
Purpose: To meet the challenges of the precision medicine era, quality assessment of shared sarcoma care becomes pivotal. The MDT approach is the most important parameter for a successful outcome. Of all MDT disciplines, surgery is the key step to rendering sarcoma patients [...] Read more.
Purpose: To meet the challenges of the precision medicine era, quality assessment of shared sarcoma care becomes pivotal. The MDT approach is the most important parameter for a successful outcome. Of all MDT disciplines, surgery is the key step to rendering sarcoma patients disease free; therefore, defining its spectrum is critical. To the best of the authors’ knowledge, a comprehensive interoperable digital platform to assess the scope of sarcoma surgery in its full complexity is lacking. Methods: An interoperable digital platform on sarcoma surgery has been created to assess the clinical exposure, tumor characteristics, and surgical settings and techniques applied for both resections and reconstructions of sarcomas. Results: The surgical exposure of an individual surgeon over time served as a pilot. Over the study period of 10 years, there were 723 sarcoma board/MDT meetings discussing 3130 patients. A total of 1094 patients underwent 1250 surgical interventions on mesenchymal tumors by one single sarcoma surgeon. These included 615 deep soft tissue tumors (197 benign, 102 intermediate, 281 malignant, 27 simulator, 7 metastasis, 1 blood); 116 superficial soft tissue tumors (45 benign, 12 intermediate, 40 malignant, 18 simulator, 1 blood); and 519 bone tumors (129 benign, 112 intermediate, 182 malignant, 18 simulator, 46 metastasis, 14 blood, and 18 sequelae of first treatment). Detailed types of resections and reconstructions were analyzed. Conclusions: An interoperable digital data platform on sarcoma surgery with transparent real-time descriptive analytics is feasible and enables large-scale definition of the spectrum of sarcoma surgery to meet the challenges of sarcoma precision care in the future. Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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12 pages, 1724 KiB  
Article
Quality of Sarcoma Care: Longitudinal Real-Time Assessment and Evidence Analytics of Quality Indicators
by Philip Heesen, Gabriela Studer, Beata Bode, Hubi Windegger, Benjamin Staeheli, Paul Aliu, Javier Martin-Broto, Alessandro Gronchi, Jean-Yves Blay, Axel Le Cesne and Bruno Fuchs
Cancers 2023, 15(1), 47; https://doi.org/10.3390/cancers15010047 - 22 Dec 2022
Cited by 14 | Viewed by 2842
Abstract
Sarcomas represent a large group of rare to very rare diseases, requiring complex management with a transdisciplinary approach. Overall progress has been hampered because of discipline, institution and network fragmentation, and there is no global data harmonization or quality standards. To report on [...] Read more.
Sarcomas represent a large group of rare to very rare diseases, requiring complex management with a transdisciplinary approach. Overall progress has been hampered because of discipline, institution and network fragmentation, and there is no global data harmonization or quality standards. To report on and improve quality, a common definition of quality indicators (QIs) of sarcoma care as well as the capacity to assess longitudinal real-time data is required. An international advisory board of world-renowned sarcoma experts defined six categories of QIs, totaling more than 80 quality indicators. An interoperable (web-based) digital platform was then created combining the management of the weekly sarcoma board meeting with the sarcoma registry and incorporating patient-reported outcome measures (PROMs) into the routine follow-up care to assess the entire care cycle of the patient. The QIs were then programmed into the digital platform for real-time analysis and visualization. The definition of standardized QIs covering all physician- (diagnostics and therapeutics), patient- (PROMS/PREMS), and cost-based aspects in combination with their real-time assessment over the entire sarcoma care cycle can be realized. Standardized QIs as well as their real-time assessment and data visualization are critical to improving the quality of sarcoma care. By enabling predictive modelling and introducing VBHC, precision health care for a complex disease is on the horizon. Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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Review

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17 pages, 872 KiB  
Review
Establishment, Maintenance, and Performance of the Cooperative Osteosarcoma Study Group (COSS)
by Stefan S. Bielack, Leo Kager, Thomas Kühne, Thorsten Langer, Peter Reichardt, Claudia Blattmann, Matthias Kevric, Vanessa Mettmann, Benjamin Sorg and Stefanie Hecker-Nolting
Cancers 2023, 15(5), 1520; https://doi.org/10.3390/cancers15051520 - 28 Feb 2023
Cited by 8 | Viewed by 2731
Abstract
Introduction: Osteosarcoma treatment has benefitted greatly from collaborative research. This paper describes the history and accomplishments of the Cooperative Osteosarcoma Study Group (COSS), mainly dedicated to clinical questions, as well as remaining challenges. Materials and Methods: Narrative review of over four decades of [...] Read more.
Introduction: Osteosarcoma treatment has benefitted greatly from collaborative research. This paper describes the history and accomplishments of the Cooperative Osteosarcoma Study Group (COSS), mainly dedicated to clinical questions, as well as remaining challenges. Materials and Methods: Narrative review of over four decades of uninterrupted collaboration within the multi-national German–Austrian–Swiss COSS group. Results: Since its very first prospective osteosarcoma trial starting in 1977, COSS has continuously been able to provide high-level evidence on various tumor- and treatment-related questions. This includes both the cohort of patients enrolled into prospective trials as well as those patients excluded from them for various reasons, followed in a prospective registry. Well over one hundred disease-related publications attest to the group’s impact on the field. Despite these accomplishments, challenging problems remain. Discussion: Collaborative research within a multi-national study group resulted in better definitions of important aspects of the most common bone tumor, osteosarcoma, and its treatments. Important challenges continue to persist. Full article
(This article belongs to the Special Issue Global Management of Sarcoma Data: Is Real-Time Predictive Analytics on the Horizon?)
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