(P 206) IMPACT OF PROXIMITY TO HEALTH CENTER ON ADHERENCE TO NATIONAL COMPREHENSIVE CANCER NETWORK GUIDELINES IN PATIENTS WITH SOFT TISSUE SARCOMAS

Objective: Soft tissue sarcomas (STS) are a relatively rare malignancy, with approximately 13,590 cases diagnosed annually. Due to their infrequency and complexity, the National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines to guide the workup and treatment of STS. Adherence to these guidelines is crucial, as demonstrated by studies showing improved survival outcomes with compliance. However, factors influencing adherence, such as proximity to treatment centers, remain underexplored. This study aims to assess NCCN guideline adherence at a single academic institution in 2023 and identify factors affecting compliance.

Methods: We performed a retrospective review of patients diagnosed with or treated for soft tissue sarcomas at a single academic institution in 2023. In concordance with NCCN guidelines, based on tumor staging we reviewed whether patients received the proper workup and treatment including a history & physical, primary site imaging, core needle biopsy (CNB), chest/abdominal imaging, presentation to multidisciplinary team, wide resection surgery, radiation therapy, and chemotherapy.

Results: A total of 43 patients were included in the study. The most common diagnoses were spindle cell sarcoma and undifferentiated pleomorphic sarcoma (22.73% each). The most common TNM stage was IV (51.16%). All patients (100%) met workup compliance according to the NCCN guidelines. Thirty four patients (79.07%) completed their treatment course adhering to the NCCN guidelines to completion. Two (4.65%) underwent a complete workup but were seen as second opinions and returned to their previous provider to complete their care. Three (6.98%) were recommended for further treatment of either radiation therapy or chemotherapy but declined. These cases had travel distances of 1.5, 10.9, and 22.5 miles. Four (9.30%) passed away while undergoing treatment. Travel distance ranged from 1.5 to 201 miles, with a median distance of 31 miles and a median travel time of 55 minutes.

Conclusion: Our findings demonstrate a high rate of compliance with NCCN guidelines at a single academic institution. Contrary to expectations, proximity to the cancer center did not significantly affect adherence. Further studies are needed to explore additional factors influencing non-compliance, such as socioeconomic and healthcare system barriers.