Evidence map›Paper›PMID 41417615›Full record

ArticleCancer2026

Exploring hospital volume thresholds for improved sarcoma treatment across different age categories in the United States.

Charbel Chidiac, Paul Phan, Katherine M McDermott, Christine A Pratilas, Adam S Levin, Christian F Meyer, Nicolas J Llosa, Alejandro V Garcia, Mark B Slidell, Daniel S Rhee

Abstract read
In one paragraph

Article in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Charbel ChidiacDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0003-2294-8479
Paul PhanJohns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Katherine M McDermottDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Christine A PratilasDepartment of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA.
Adam S LevinDepartment of Orthopaedic Surgery, Division of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Christian F MeyerDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Nicolas J LlosaDepartment of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA.
Alejandro V GarciaDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mark B SlidellDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Daniel S RheeDepartment of Surgery, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Funding

PROJECT 3: Applying Liquid Biopsy Technologies to Detect Clinical Response and Mechanisms of Resistance in the Treatment of LMSP50CA272170 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI JUDY E. GARBER · 2022 to 2026
$13.3M
NCI NIH HHS P50 CA272170
6 · The paper itself

Abstract

introductionSarcoma management is complex, requiring multidisciplinary care. Previous studies show improved outcomes at high-volume hospitals (HVHs), but optimal volume thresholds remain unclear. The aim was to identify hospital volume thresholds associated with improved survival for sarcoma patients across age groups.

methodsPatients with Ewing sarcoma, osteosarcoma, rhabdomyosarcoma, and nonrhabdomyosarcoma soft-tissue sarcoma were queried from the National Cancer Database (2004-2020). Patients were divided into children (0-17 years), young adults (YA) (18-39 years), and adults (≥40 years). The primary outcome was overall survival. Restricted cubic splines identified volume thresholds, which were validated using Kaplan-Meier curves and Cox regression.

resultsAmong 71,463 patients, 7829 (10.9%) were children, 12,901 (18.1%) were YA, and 50,733 (71.0%) were adults. Identified HVH thresholds were 37 cases/year for all ages, five for children and YA, and 24 for adults. Using these thresholds, 17/1289 hospitals were HVHs for all ages, 30/413 for children, 40/970 for YA, and 19/1264 for adults. Treatment at HVHs was associated with better 5-year overall survival compared to low-volume hospitals for all ages (64.8% vs. 60.0%, p < .001) and adults (63.0% vs. 56.8%, p < .001). In multivariable analysis, HVH treatment was associated with better survival across all groups: all ages (adjusted hazard ratio [aHR], 0.85; 95% CI, 0.83-0.88), children (aHR, 0.91; 95% CI, 0.83-0.98), YA (aHR, 0.94; 95% CI, 0.88-0.99), and adults (aHR, 0.81; 95% CI, 0.78-0.85).

conclusionTreatment at HVHs is associated with improved survival for sarcoma patients across all age groups. Our study defines distinct volume thresholds for children, young adults, and adults, guiding referrals and optimizing care.

Indexed as

Hospitals, High-VolumeHospitals, Low-VolumeSarcomaAdolescentAdultAgedAge FactorsChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleMiddle AgedUnited Stateshospital volumeosteosarcomapediatric cancerrhabdomyosarcomasarcomasurvival

Identifiers

PMID41417615
PMCPMC13412038

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.