An audit of the management of soft tissue sarcoma within a health region in the UK

Glencross, J; Balasubramanian, Sabapathy P; Bacon, James; Robinson, Martin; Reed, Malcolm

doi:10.1016/s0748-7983(03)00134-3

Cited by 15 publications

(5 citation statements)

References 4 publications

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“…In the past decade, there has been a move to manage all malignancies through regionally accredited multidisciplinary teams (MDT). Sarcoma services have lagged behind the more common solid tumours in this process, so patients with soft tissue sarcomas are often treated by nonspecialist orthopaedic, plastic, or general surgeons (Clasby et al [ 13 ]; Glencross et al [ 14 ]). Our survey included only those with a declared interest in sarcoma, of whom 91% had access to an MDT.…”

Section: Discussionmentioning

confidence: 99%

Follow up after Primary Treatment of Soft Tissue Sarcoma: A Survey of Current Practice in the United Kingdom

Gerrand

Billingham

Woll

et al. 2007

Sarcoma

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Despite the clinical and financial implications, there is little evidence about how patients who have been treated for soft tissue sarcoma should be followed up. The purpose of this study was to determine current practice in the United Kingdom. 192 clinicians treating patients with soft tissue sarcoma were surveyed with a postal questionnaire enquiring about frequency and method of follow up and how patients would be followed up in each of 3 clinical scenarios: a patient with a trunk or extremity tumour at low risk of relapse; a patient with a trunk or extremity tumour at high risk of relapse; and a patient with a retroperitoneal or abdominal tumour. 155 (81%) clinicians responded. Clinic visits and X-rays were the most frequently used methods of follow up. Chest CT scans, local site imaging, and blood tests were used infrequently. The intensity and methods of follow up varied with each of the clinical scenarios. There was a seven-to-twenty fold variation in cost between the least and the most expensive regimes. Respondents were generally supportive of the development of the clinical trial in this area.

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Section: Discussionmentioning

confidence: 99%

Follow up after Primary Treatment of Soft Tissue Sarcoma: A Survey of Current Practice in the United Kingdom

Gerrand

Billingham

Woll

et al. 2007

Sarcoma

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“…In the Trent Cancer Registry region, median size at presentation to the sarcoma service was 8 cm (range: 0.3–45 cm) [8] and data from the Scandinavian Sarcoma Group Register shows a median size of 7 cm at presentation, varying with age, with a larger median tumour size in older patients [9]. At our centre, however, the median size of tumour seen at first presentation is 9 cm.…”

Section: Introductionmentioning

confidence: 94%

Delays in Referral of Soft Tissue Sarcomas

Johnson

Smith

Dramis

et al. 2008

Sarcoma

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Introduction and aims. It is well established that soft tissue sarcomas (STSs) are more effectively treated in a specialist centre. However, delays in time taken for a patient to be referred to a specialist centre may lead to a poorer prognosis. This study aims to identify the length of these delays and where they occur. Patients and methods. Patients with a proven STS were included. They were recruited from both outpatient clinics and from the surgical ward of the Royal Orthopaedic Hospital (Birmingham, UK). A structured interview was used to take a detailed history of the patients' treatment pathway, before arriving at the specialist centre. Dates given were validated using the case notes. Results. The median time for the patient to present to a specialist centre from the onset of symptoms was 40.4 weeks. The median delay until presentation to a medical professional (patient delay) was 1.3 weeks. Median delay in referral to a specialist centre (service delay) was 25.0 weeks. Discussion. Medical professionals rather than patients contribute the greatest source of delay in patients reaching a specialist centre for treatment of STS. Adherence to previously published guidelines could decrease this delay for diagnosis of possible sarcoma. Steps should be taken to refer patients directly to a diagnostic centre if they have symptoms or signs suggestive of STS.

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“…14 Previous studies into the management of sarcomas have examined both the average size and the duration of symptoms for soft tissue sarcomas as well as the duration of symptoms alone for bone sarcomas. [15][16][17][18] However, these studies have not investigated what factors influence either the size of these tumours at presentation or whether there has been a change with time. We also wanted to investigate whether the DH guidance had led to any reduction in the size of the tumours or symptom duration of patients by the time of diagnosis.…”

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confidence: 99%

Trends in presentation of bone and soft tissue sarcomas over 25 years: little evidence of earlier diagnosis

Smith

Johnson

Grimer

et al. 2011

annals

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Earlier diagnosis is a key aim in achieving improved outcomes for patients with cancer. Bone and soft tissue sarcomas represent approximately 1% of all malignant tumours. Delays in diagnosis are frequent both because of their rarity and because the clinical features are easily confused with other conditions. In 2000 advice on earlier diagnosis was widely publicised. This study investigates how two factors that may act as a proxy for delay in diagnosis have varied over a 25-year period and whether there is evidence of improvement. Data on symptom duration and tumour size were collected prospectively on all new sarcoma patients referred to an orthopaedic oncology unit over 25 years. Data were available for 2,568 patients with primary bone sarcomas and 2,366 with soft tissue sarcomas. The mean sarcoma size at diagnosis was 10.7cm and 9.9cm respectively. The size of bone sarcomas had not changed over time but there had been a slight decrease in the size of soft tissue sarcomas (10.3cm before 2000 vs 9.6cm after 2000, p=0.03). The duration of symptoms reported by patients varied widely with a median of 16 weeks for bone sarcomas and 26 weeks for soft tissue sarcomas. The median duration of symptoms for bone sarcomas had actually increased since 2000 (16 weeks before vs 20 weeks after 2000, p<0.01). It remained unchanged for soft tissue sarcomas. These data show there is huge room for improvement in diagnosing bone and soft tissue sarcomas. New strategies are needed urgently.

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An audit of the management of soft tissue sarcoma within a health region in the UK

Cited by 15 publications

References 4 publications

Follow up after Primary Treatment of Soft Tissue Sarcoma: A Survey of Current Practice in the United Kingdom

Follow up after Primary Treatment of Soft Tissue Sarcoma: A Survey of Current Practice in the United Kingdom

Delays in Referral of Soft Tissue Sarcomas

Trends in presentation of bone and soft tissue sarcomas over 25 years: little evidence of earlier diagnosis

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