Population-based studies in sarcoma research

Abstract

Many study designs are used to provide the answers needed to further the care of orthopedic oncology patients. Underlying these differing study designs, are different data sets. The data sets vary in their size and scope, from single center to population-based, and from provincial to international. They vary in their follow-up time, from years to decades. They vary in the variables included, the fidelity and precision of each variable, and the granularity of detail. This thesis explores the use of population-based studies as a source of data on orthopedic oncology patients, and provides two studies as an example. We make use of the large administrative data collected from every soft tissue sarcoma (STS) patient in Ontario over 23 years by the Institute of Clinical Evaluative Sciences (ICES) to answer two questions only possible with population-based studies. Using this large cohort (n=8,896) we provide for the first-time answers to 1) Given the multidisciplinary treatment of sarcoma patients, how are Ontario sarcoma patients being treated in our universal healthcare system, and, have treatment strategies changed over the past 10 years? 2) What are the long-term survival outcomes of Ontario sarcoma patients? Do these outcomes differ for rural or low-income patients? These studies have engendered international collaborations which are also described. Overall, this thesis explores research questions that are possible to address with population-based data. Through two studies, we aim to provide accurate and clinically useful information that can hopefully be used to better the outcomes of sarcoma patients, both in Ontario and internationally.