Abstract 1545P
Background
Early dx of sarcomas significantly impact in reduction of radical surgeries, improvement of quality of life, and prolonged survival. Herein, we characterize the clinical staging of pts with (w) soft tissue sarcoma (STS) and bone sarcomas (BS) at presentation, and evaluate the symptom-to-diagnosis (S-D) and symptom-to-treatment (S-T) intervals, comparing findings between pts from private health insurance (PrivHIn) and public health insurance (PubHIn) treated in a Brazilian cancer center.
Methods
Retrospective chart review was performed for pts > 18 y diagnosed w STS or BS at our center (2011 - 2019). Histologies included: leiomyosarcoma (LMS), liposarcoma (LPS), undifferentiated pleomorphic sarcoma (UPS), synovial sarcoma, malignant peripheral nerve sheath tumor, myxofibrosarcoma, osteosarcoma (OS), chondrosarcoma (CS), and Ewing sarcoma. Pts who initiated treatment at another hospital were excluded, as those diagnosed during follow up of another cancer.
Results
416 pts were included: 318 (76.4%) from PrivHIn and 98 (23.6%) from PubHIn. Median age at dx was 50 y (18 – 85 y). Most pts were ≤ 60 y (72.8%), and 223 were women. STS represented 80.8%, and BS 19.2%. Most frequent STS were LMS (31.5%), LPS (30.9%), and UPS (17.6%). Of the BS, OS represented 45%, followed by CS (42.5%). 94% of the tumors were grade 3. At dx, median size of tumors in the PrivHIn was 8 cm (0.6 – 45 cm) vs 10 cm (0.8 – 33 cm) in PubHIn (p = 0.02). Metastasis were present in 43 pts in PrivHIn (13.5%) and in 17 from PubHIn (17.3%), p = 0.43. Median S-D interval was 6 m in PubHIn and 5 m in PrivHIn (p = 0.4), and median S-T interval was 7 m in PubHIn and 6 m in PrivHIn (p = 0.4). Histological grade 3 was associated w metastasis at dx (p = 0.02). There was no OS difference between PrivHIn and PubHIn pts.
Conclusions
Pts from PubHIn presented significantly larger lesions, but no difference in metastatic disease at dx. S-D and S-T intervals were high in both groups, which highlights the long journey from symptoms to treatment and suggests low expertise in sarcoma management among community health services in Brazil. Further studies are needed to understand if discrepancy in tumor size at dx results in more mutilating surgeries, worst quality of life, and higher costs of treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.