Abstract 59P
Background
STS are a rare and heterogeneous group of tumors often associated with diagnostic delays. Published studies have not clarified the reasons for these delays or their impact on patient OS. This retrospective study analyzed high-risk STS patients evaluated at our center between October 2018-October 2022. The study aimed to explore correlations between diagnostic intervals and survival outcomes.
Methods
The following intervals were analyzed: Total interval (TI): From first symptom (FS) to histological diagnosis (HD). Diagnostic interval (DI): From first medical consultation (FMC) to HD. Patient interval (PI): From FS to FMC. Primary care interval (PCI): From FMC to evaluation by a specialist (S) or sarcoma specialist (SS). Secondary care interval (SCI): From S evaluation to SS evaluation. Tertiary care interval TCI): From SS evaluation to histological diagnosis. Statistical analysis included chi-square tests and Cox regression models. Kaplan-Meier curves were used for survival analysis.
Results
52 pts were included. Descriptive analyses and collected characteristics are detailed in the table. Median intervals (in weeks) were: IT 33 (0.43–162), DI 9.4 (0.14–35.14), PI 23.6 (0–142.7), PCI 5.2 (0.14–21.14), SCI 6.96 (0–35), and TCI -1.4 (-22.4–7.14). The TI is prolonged primarily due to the PI. Pts with DI ≤6 months demonstrated longer OS compared to those with >6 months (58.5 ± 5.34 months vs. 47.19 ± 5.64 months), although the difference was not statistically significant (p = 0.123). DI were shorter when pts were directly referred to a SS from the FMC, bypassing intermediate S (median DI: 4.5 weeks [0.14–18] vs. 11 weeks [0.29–35.1]). No statistically significant correlations were found between the studied variables and diagnostic intervals. Table: 59P
| % | Correlation with longer TI (> 6 months) | |
| Male/Female | 65.4 / 34.6 | p=0.244 |
| Extremities/trunk wall | 71.2 / 28.8 | p=0.310 |
| Firts symptom: Growth/pain/other | 82.7 / 15.4 / 1.9 | p=0.714 |
| First imaging test: ultrasound / CT / NMR/ none | 67.5 / 11.5 / 9.6 / 1.9 | p=0.898 |
| Localized/metastatic at diagnosis | 92.3 / 7.7 | p=0.5 |
| Surgery: Yes/No | 86.5 / 13.5 | p=0.685 |
| Size <5/>5 cm | 28.8 / 23.2 | p=0.358 |
Conclusions
Raising global awareness about the symptoms and diagnosis of STS among primary care providers and the general public is essential to reduce diagnostic delays and potentially improve patient survival outcomes.
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.