Research Article

The Volume-Outcome Relationship in Retroperitoneal Soft Tissue Sarcoma: Evidence of Improved Short- and Long-Term Outcomes at High-Volume Institutions

Table 1

Patient characteristics: all patients.

High volume (N = 563)Medium volume (N = 373)Low volume (N = 4471)Total (N = 5407) value

Age at diagnosis0.0085
 Mean (SD)59.6 (14.3)58.5 (14.4)60.7 (14.2)60.4 (14.2)
 Median60.059.062.061.0
Q1, Q351.0, 70.050.0, 68.052.0, 71.052.0, 71.0
 Range(19.0–90.0)(18.0–88.0)(18.0–90.0)(18.0–90.0)

Sex0.0001
 Male304 (54.0%)193 (51.7%)2028 (45.4%)2525 (46.7%)
 Female259 (46.0%)180 (48.3%)2443 (54.6%)2882 (53.3%)

Race0.0010
 Black34 (6.0%)30 (8.0%)500 (11.2%)564 (10.4%)
 Other29 (5.2%)26 (7.0%)271 (6.1%)326 (6.0%)
 White500 (88.8%)317 (85.0%)3700 (82.8%)4517 (83.5%)

Charlson–Deyo score0.0047
 0472 (83.8%)307 (82.3%)3500 (78.3%)4279 (79.1%)
 179 (14.0%)52 (13.9%)755 (16.9%)886 (16.4%)
 212 (2.1%)14 (3.8%)216 (4.8%)242 (4.5%)

Year of diagnosis0.37
 200449 (8.7%)20 (5.4%)353 (7.9%)422 (7.8%)
 200541 (7.3%)25 (6.7%)392 (8.8%)458 (8.5%)
 200656 (9.9%)37 (9.9%)404 (9.0%)497 (9.2%)
 200756 (9.9%)38 (10.2%)422 (9.4%)516 (9.5%)
 200866 (11.7%)37 (9.9%)453 (10.1%)556 (10.3%)
 200964 (11.4%)34 (9.1%)452 (10.1%)550 (10.2%)
 201051 (9.1%)38 (10.2%)479 (10.7%)568 (10.5%)
 201168 (12.1%)48 (12.9%)522 (11.7%)638 (11.8%)
 201259 (10.5%)59 (15.8%)508 (11.4%)626 (11.6%)
 201353 (9.4%)37 (9.9%)486 (10.9%)576 (10.7%)

Facility type<0.0001
 Missing4839364451
 Community cancer program0 (0.0%)1 (0.3%)230 (5.6%)231 (4.7%)
 Comprehensive community cancer program0 (0.0%)0 (0.0%)1428 (34.8%)1428 (28.8%)
 Academic/research program515 (100.0%)283 (84.7%)2023 (49.3%)2821 (56.9%)
 Integrated network cancer program0 (0.0%)50 (15.0%)426 (10.4%)476 (9.6%)

Primary payor<0.0001
 Not insured7 (1.2%)10 (2.7%)181 (4.0%)198 (3.7%)
 Private insurance243 (43.2%)195 (52.3%)2127 (47.6%)2565 (47.4%)
 Medicaid17 (3.0%)25 (6.7%)271 (6.1%)313 (5.8%)
 Medicare168 (29.8%)131 (35.1%)1774 (39.7%)2073 (38.3%)
 Other government5 (0.9%)1 (0.3%)61 (1.4%)67 (1.2%)
 Insurance status unknown123 (21.8%)11 (2.9%)57 (1.3%)191 (3.5%)

Median income quartiles0.0078
 Missing3610159205
 <$30,00036 (6.8%)41 (11.3%)547 (12.7%)624 (12.0%)
 $30,000–$35,99998 (18.6%)67 (18.5%)716 (16.6%)881 (16.9%)
 $36,000–$45,999139 (26.4%)101 (27.8%)1124 (26.1%)1364 (26.2%)
 $46,000+254 (48.2%)154 (42.4%)1925 (44.6%)2333 (44.8%)

No high school degree (%)<0.0001
 Missing3610159205
 ≥29%58 (11.0%)33 (9.1%)681 (15.8%)772 (14.8%)
 20–28.9%96 (18.2%)91 (25.1%)961 (22.3%)1148 (22.1%)
 14–19.9%125 (23.7%)96 (26.4%)994 (23.1%)1215 (23.4%)
 <14%248 (47.1%)143 (39.4%)1676 (38.9%)2067 (39.7%)

Distance to treating center (miles)<0.0001
 Mean (SD)223.5 (389.7)68.2 (119.1)39.5 (136.1)60.6 (187.7)
 Median75.938.412.415.4
Q1, Q322.4, 242.715.0, 89.85.1, 33.55.8, 46.2
 Range(1.0–4040.1)(1.0–1495.6)(1.0–4710.1)(1.0–4710.1)

Histologic subtype<0.0001
 Dedifferentiated liposarcoma160 (28.4%)81 (21.7%)755 (16.9%)996 (18.4%)
 Fibrosarcoma10 (1.8%)5 (1.3%)67 (1.5%)82 (1.5%)
 Leiomyosarcoma98 (17.4%)88 (23.6%)1069 (23.9%)1255 (23.2%)
 Liposarcoma188 (33.4%)98 (26.3%)1468 (32.8%)1754 (32.4%)
 MFH5 (0.9%)5 (1.3%)96 (2.1%)106 (2.0%)
 MPNST6 (1.1%)6 (1.6%)42 (0.9%)54 (1.0%)
 Rare/NOS96 (17.1%)90 (24.1%)974 (21.8%)1160 (21.5%)

Grade<0.0001
 Missing97719921160
 Well differentiated172 (36.9%)85 (28.1%)1256 (36.1%)1513 (35.6%)
 Mod differentiated23 (4.9%)38 (12.6%)587 (16.9%)648 (15.3%)
 Poorly differentiated99 (21.2%)111 (36.8%)1019 (29.3%)1229 (28.9%)
 Undifferentiated172 (36.9%)68 (22.5%)617 (17.7%)857 (20.2%)

Tumor size0.35
 Missing3617327380
 5–10 cm98 (18.6%)80 (22.5%)848 (20.5%)1026 (20.4%)
 <5 cm42 (8.0%)27 (7.6%)391 (9.4%)460 (9.2%)
 >10 cm387 (73.4%)249 (69.9%)2905 (70.1%)3541 (70.4%)

AJCC stage group<0.0001
 Stage I180 (32.0%)90 (24.1%)1322 (29.6%)1592 (29.4%)
 Stage II49 (8.7%)39 (10.5%)560 (12.5%)648 (12.0%)
 Stage III204 (36.2%)140 (37.5%)1278 (28.6%)1622 (30.0%)
 Stage IV38 (6.7%)20 (5.4%)314 (7.0%)372 (6.9%)
 AJCC staging not applicable22 (3.9%)27 (7.2%)275 (6.2%)324 (6.0%)
 AJCC stage group unknown70 (12.4%)57 (15.3%)722 (16.1%)849 (15.7%)

Surgery<0.0001
 No53 (9.4%)73 (19.6%)1198 (26.8%)1324 (24.5%)
 Yes510 (90.6%)300 (80.4%)3273 (73.2%)4083 (75.5%)

Radiation<0.0001
 Missing017980
 No453 (80.5%)293 (78.8%)3196 (72.8%)3942 (74.0%)
 Yes110 (19.5%)79 (21.2%)1196 (27.2%)1385 (26.0%)

Chemotherapy0.0001
 Missing611188205
 No469 (84.2%)270 (74.6%)3569 (83.3%)4308 (82.8%)
 Yes88 (15.8%)92 (25.4%)714 (16.7%)894 (17.2%)

Last contact or death, months from Dx0.68
 Mean (SD)41.7 (27.4)42.3 (31.6)43.8 (32.2)43.5 (31.7)
 Median37.635.837.237.1
Q1, Q320.0, 58.016.8, 61.017.9, 64.818.1, 63.5
 Range(0.6–133.1)(1.2–132.5)(0.0–142.6)(0.0–142.6)

Vital status<0.0001
 Dead177 (31.4%)151 (40.5%)1954 (43.7%)2282 (42.2%)
 Alive386 (68.6%)222 (59.5%)2517 (56.3%)3125 (57.8%)

Hospital volume<0.0001
 Mean (SD)153.7 (46.5)62.6 (5.0)14.4 (12.5)32.2 (47.1)
 Median134.064.010.013.0
Q1, Q3114.0, 212.062.0, 65.05.0, 22.06.0, 35.0
 Range(103.0–212.0)(51.0–68.0)(1.0–47.0)(1.0–212.0)