OBJECTIVES:

Soft tissue sarcomas (STS) are rare malignancies. Both their low-incidence and the complexity of the disease management demand the treatment in high volume multidisciplinary centers to assure quality of care. This research aimed to assess the costs and performance of quality indicators of STS care in Veneto Region (North-East Italy).

METHODS:

This population-based cohort study included all incidental STS cases recorded in 2018 in Veneto Region. The average per-patient real-world costs over this two-year period, overall and by single expenditure item (hospitalization, outpatient health care services, palliative care, drug prescription, medical devise), survival weighted and unweighted costs were calculated and stratified by stage of disease at diagnosis, tumor histology and tumor site.

Moreover, a multidisciplinary regional working experts’ group (RWG) identified a set of indicators (15) for monitoring the quality of different phases of clinical pathways.

RESULTS:

The survival weighted mean total cost per patient, into two years from diagnosis, amounted to €22,183, particularly €40,042 in stage IV cases and € 10,379 in stage I cases. A higher TNM stage at diagnosis was associated with higher healthcare costs and the highest cost item consisted in hospitalization. Diagnostic procedures showed low adherence for example only 49% of the initial anatomo-pathological diagnoses were supported by a second opinion. Indicators referred to surgical treatment of intermediate/high-grade and retroperitoneal STS indicators’ values significantly lower than thresholds, as only 37% of the latter were treated with multivisceral surgery.

CONCLUSIONS:

The present study results can estimate population based both direct costs of illness of incident cases of STS into two year from diagnosis and give an overview on quality of care of sarcoma clinical pathways.