Initial report from the SAR-TRACK (SELNET) registry: a multicentric international retrospective analysis on the quality of the management of limb and trunk wall soft-tissue sarcomas (2012–2022) in Ibero-American countries

Background: Multidisciplinary (MDT) management of sarcoma patients, with adherence to clinical practice guidelines (CPG), has a positive impact on patients' outcomes. Sarcoma European & Latin-American Network (SELNET) is an international consortium aiming to improve sarcoma management in Ibero-America. This study presents data from the observational study Sar-Track, which assessed the adherence of SELNET institutions to CPGs. This study aimed to evaluate adherence to established quality indicators in the diagnostic and therapeutic management of patients with soft tissue sarcoma within the SELNET network. Methods: Data from sarcoma patients managed in SELNET institutions (2012-2022) were collected. The primary objective was to analyze the adherence to quality factors during diagnosis and treatment, comparing Ibero-American (IA) and Spanish (SP) institutions. Findings: Data from 1523 localized patients with sarcoma of limbs or trunk-wall were included in this analysis. The median age was 50 (28), with 780 (51%) being female in the whole series. Ethnicity data was not available. Patients managed in IA underwent fewer core biopsies [n = 138 (25%) vs n = 153 (57%), p < 0.0001], fewer magnetic resonance imaging (MRI) [n = 464 (59%) vs 500 (68%), p = 0.003], and fewer MDT discussions before surgery [n = 208 (27%) vs 737 (99.6%), p < 0.0001]. Surgical margin involvement occurred more often in IA cases [n = 215 (27%) vs n = 61 (9%), p < 0.0001], and less radiotherapy was administered in patients from IA [n = 172 (37%) vs n = 185 (62%), p < 0.0001]. Interpretation: This analysis establishes the baseline reality at the initial stage of SELNET, highlighting substantial opportunities for improving adherence to CPGs in Ibero-America. Funding: SELNET was supported by a European Horizon 2020 grant (H2020-SC1-BHC-2018-2020).