Dutch Cancer Society (KWF Kankerbestrijding) subsidises statistical research
Marta Fiocco, professor at the Mathematical Institute, has received a grant for predicting survival outcome and improving the balance between prognosis and quality of life for soft tissue sarcoma patients (Personalised Sarcoma Care).
Patients with high-grade sarcoma (bone tumour) of the extremities, often face a difficult decision in the shared decision making of their surgical treatment, since risk prediction models balancing both cure of the sarcoma and quality of life are not only scarce, but also have little validity. Radiotherapy and wide surgical resection are the main treatments; surgical tumour margins are necessary for cure, but the degree of surgical morbidity is also largely determined by these surgical margins. Both determine quality of life after intervention. The prognostic relevance of surgical margins and local recurrence on survival, in the context of specific subgroups of patients with high-grade soft tissue sarcomas differs largely.
Prognostic models in cancer treatment focus on prognosis at one well-defined baseline moment, mainly at time of diagnosis. It is at this time that the most important decisions on primary treatment are made. However, once the primary surgical treatment has been provided, patient’s prognosis may change over time. Clinical events such as local recurrence or distant metastasis that may occur after surgery must be taken into account.
Within this project a dynamic prognostic model predicting the risk for local recurrence and/or distant metastases for different treatment protocols, given patient and tumour related risk factors, identified at diagnosis and collected during the follow up, will be developed. An online prediction tool will be made available for clinicians collaborating to the project via hospital websites through a user-friendly web application and an app.
Relevance for cancer research
The methodology of this research project can be applied to orphan cancerous diseases to be used by other multidisciplinary teams to improve prognosis and patients care. The model will be made available to other collaborating research groups.
Two PhD students are working on this project Anja Juana Rüten-Budde at the Mathematical Institute and Veroniek van Praag at the Department of Orthopaedic (Leiden University Medical Centre). Dr MAJ van de Sande (Orthopaedic Surgeon at LUMC) is the second project leader involved in the project . Statisticians at Leiden University have joined in offering a full program in statistical science, with medical applications as one of the focus points.