title: [How to improve the initial management of adult patients with tumors of bone and soft tissues: the experience of a multidisciplinary committee from the Oncolor network before the distribution of regional guidelines].
abstract: Tumors of bone and soft tissues in adults are rare accounting in France for 2000 to 2500 new cases per year. These tumors are heterogenous and their diagnosis is made after first surgery. Therefore, an early pluridisciplinary approach, by physicians who have acquired an expertise in this field, is advised before any biopsy or surgical resection and at all the further step in the subfrequent management. This paper describes the experience of a pluridisciplinary committee, specialized in malignant tumors of bone and soft tissues in adults, with a highly specialized team which is part of a network in the treatment of cancer in Lorraine, the Oncolor network, before the distribution of regional guidelines. After a description of the organisation of this committee, we made a retrospective analysis of all the cases submitted to these experts advice for the first time, between January and December 2000. This study reveals an insufficient pluridisciplinary coordination at the initial management, which has been done by making regional referentials available, and therefore some errors which lead in some cases to inadapted treatment. It underlines therefore the necessity to implement more actively the present data of science, and to develop the management in multidisciplinary committees. Oncolor aims to harmonize this pluridisciplinary approach as well as to diffuse standard recommendations.
authors.affiliation: Centre régional de lutte contre le cancer Alexis-Vautrin, avenue de Bourgogne 54511 Vandoeuvre-lès-Nancy. l.uwer@nancy.fnclcc.fr
authors.forename: Lionel
authors.initials: L
authors.lastname: Uwer
authors.forename: Maria
authors.initials: M
authors.lastname: Rios
authors.forename: Danièle
authors.initials: D
authors.lastname: Sommelet
authors.forename: Daniel
authors.initials: D
authors.lastname: Mole
authors.forename: François
authors.initials: F
authors.lastname: Sirveaux
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Verhaeghe
authors.forename: Joseph
authors.initials: J
authors.lastname: Stines
authors.forename: Pierre
authors.initials: P
authors.lastname: Bey
mesh_terms: D000328:Adult; D001706:Biopsy / Q000592:standards; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002813:Chondrosarcoma / Q000175:diagnosis / Q000628:therapy; D003952:Diagnostic Imaging; D006801:Humans; D033183:Interdisciplinary Communication; D008495:Medical Oncology; D008499:Medical Records; D012516:Osteosarcoma / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D011367:Professional Staff Committees / Q000458:organization & administration*; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis* / Q000628:therapy*; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000628:therapy