ReviewOrthopadie (Heidelberg, Germany)2026
[Should the surgical treatment of primary malignant bone tumors only take place in high-volume centers?]
Review in Orthopadie (Heidelberg, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
7 authors.
Funding
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Abstract
backgroundPrimary malignant bone tumors are rare, biologically heterogeneous malignancies that require highly specialized, multidisciplinary treatment. Surgical excision of the primary tumor is considered a prerequisite for long-term survival in most affected patients. An association between hospital volume and outcome has been demonstrated for numerous oncological procedures but has been investigated less extensively in the context of bone sarcomas. MAIN
findingsThe surgical expertise concentrated at high-volume centers (HVC) appears to translate directly into superior oncologic outcomes and a better prognosis. Key contributing factors include significantly lower rates of positive surgical margins and significantly reduced perioperative mortality. Furthermore, specialized surgical expertise enables limb-sparing procedures even in most complex cases. UNRESOLVED QUESTIONS: The definition of HVC has been inconsistent so far. Furthermore, centralized treatment in HVC requires the establishment of clear referral pathways and optimal cooperation between specialized centers and the wider healthcare system.
conclusionsThe surgical treatment of primary malignant bone tumors should be centralized in specialized, high-volume sarcoma centers. In this context, hospital volume should also be understood as a proxy for specialized multidisciplinary expertise, adherence to clinical practice guidelines, and systematic quality improvement, which are all essential factors for the optimal treatment of bone sarcomas. Further studies are necessary to better define the term HVC in different healthcare systems and settings.
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42509300What OpenQuestion holds
Registered trials
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.