Actualité - Patient Pathway

for improved treatment of sarcomas and tumors of the bone and soft tissue

Mathilde Regnault
Institut Curie is introducing the CUSTOM care framework, which stands for complex sarcomas and tumors of the bone and soft tissue. Its purpose? To invite general practitioners and surgeons to send their patients before any therapeutic procedure, and above all before any surgery.
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Why a new diagnostic care framework at Institut Curie?

The “diagnostic care frameworks” at Institut Curie let us organize several consultations with our specialists in a short period of time, in order to identify the exact nature of diseases and quickly decide on the most appropriate treatment. They were developed initially for lesions of the breast, and more recently, for nodules on the thyroid gland. We wanted to extend this principle of treatment to bone and soft tissue lesions, for which diagnosis is often difficult and treatment complex.

What is specific about these bone and soft tissue lesions?

These lesions develop either in the bone or in the muscles (or fat) of the limbs, the torso wall or sometimes in the abdomen or the pelvis in contact with the organs. These lesions are both rare in comparison to other tumors and extremely varied. Some of them are completely benign, some are locally aggressive (invading the neighboring structures and organs), others are very aggressive (sarcomas) and commonly recurrent.

The possible large number of lesions that can be observed makes the diagnosis complex, requiring medical imaging exams, samples (biopsies) and sophisticated analyses (that can be performed only in certain specialized laboratories).

Treatment is just as complex and must be adjusted according to each case: some lesions cannot be operated on since they can recur alone, or because they can be medically treated. Others may require surgery straight away, or after initial treatment by chemotherapy or radiotherapy. The type of surgery itself is very variable according to the type of lesion.

As a result, the initial diagnostic phase is crucial, and must be performed in a specialized center, before any medical treatment and before any surgical procedure that may be inappropriate or may even worsen the situation.

How is Institut Curie suited to treating these diseases?

In accordance with international recommendations, aggressive sarcomas and tumors of the bone and soft tissue require treatment in certified expert centers that have tailored diagnostic platforms and a full range of specialized care options that can also offer participation in a clinical trial if needed.

  • Institut Curie is one of the expert centers of the NETSARC-RESOS network (national network of centers certified by the INCa for treatment of complex sarcomas and tumors of the bone and soft tissue)
  • Institut Curie is one of the expert centers of the RRePS network (reference network for sarcoma pathology for soft tissue and visceral sarcoma) and has an efficient somatic genetics unit
  • Institut Curie is certified tor clinical trials (certified “Clinical research center” by the French ministry for health, and INCa early phase clinical trial center)
  • Institut Curie treats patients in all stages of life: from young children to the elderly, and has a specific AYA unit at its Paris site (specifically for adolescents and young adults: 15-25 years old)
  • Institut Curie offers surgical options for soft tissue sarcoma in adults and works in partnership with several departments specialized in surgical treatment of bone sarcoma in adults and sarcoma in children.