Background The coronavirus disease 2019 (COVID-19) pandemic was an unprecedented shock to the healthcare systems, and its consequences on managing rare cancers are unknown. We investigated COVID-19's impact on the activity of sarcoma-labeled networks by comparing key indicators in 2019-2020 (before and during the pandemic, respectively). Methods We compared the incidence of limb and trunk soft tissue sarcomas, surgery rate, surgery center, surgery quality, and surgery delays nationally and in various regions, focusing on the three most severely affected regions. Findings In this study, sarcoma incidence did not decrease, and the tumor and patient characteristics were similar in both years. The number of patients who underwent surgery in the labeled centers increased significantly (63% versus 57%, p = 0.015), the rate of R0 resection increased (55% versus 47%, p = 0.004), and the rate of re-excision decreased (12% versus 21%, p < 0.0001). In the univariate analysis, the time to surgery was similar in both years. Cox regression analysis revealed that the factors associated with a longer time to surgery were age > 70 years (p = 0.003), retroperitoneal location (p > 0.001), tumor size (p < 0.001), deep tumors (p < 0.001), and regions (p < 0.001). However, we have observed an increase in the time before surgery in the regions most stroked by the COVID-19 pandemic. Interpretation The model of the labeled center network for managing rare tumors was resilient. Paradoxically, the quality indicators improved during the pandemic due to the direct referral of patients with sarcomas to the labeled centers. Summary This study shows that a nationwide network organization has made it possible to maintain care for these rare tumors during the pandemic.

中文翻译：

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2019 年冠状病毒病大流行对法国肉瘤管理的影响：2019 年和 2020 年比较。

背景 2019 年冠状病毒病 (COVID-19) 大流行对医疗保健系统造成了前所未有的冲击，其对管理罕见癌症的影响尚不清楚。我们通过比较 2019-2020 年（分别在大流行之前和期间）的关键指标，调查了 COVID-19 对肉瘤标记网络活动的影响。方法比较全国和各地区四肢躯干软组织肉瘤的发病率、手术率、手术中心、手术质量和手术延误情况，重点关注三个受影响最严重的地区。结果 在这项研究中，肉瘤发病率并没有下降，而且这两年的肿瘤和患者特征相似。在标记中心接受手术的患者数量显着增加（63% vs 57%，p = 0.015），R0 切除率增加（55% vs 47%，p = 0.004），并且再次切除率增加下降（12% 与 21%，p < 0.0001）。在单变量分析中，两年的手术时间相似。Cox 回归分析显示，与手术时间较长相关的因素包括年龄 > 70 岁 (p = 0.003)、腹膜后位置 (p > 0.001)、肿瘤大小 (p < 0.001)、肿瘤深部 (p < 0.001) 和肿瘤位置。区域（p < 0.001）。然而，我们发现在受 COVID-19 大流行影响最严重的地区，手术前的时间有所增加。解释 用于管理罕见肿瘤的标记中心网络模型具有弹性。矛盾的是，由于将肉瘤患者直接转诊到标记的中心，因此在大流行期间质量指标有所改善。摘要 这项研究表明，全国性的网络组织使得在大流行期间维持对这些罕见肿瘤的护理成为可能。