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Sarcoma
Volume 2008 (2008), Article ID 378574, 7 pages
http://dx.doi.org/10.1155/2008/378574
Clinical Study

Delays in Referral of Soft Tissue Sarcomas

1Department of Medicine, Medical School, University of Birmingham, 33 Holloway, Northfield, Birmingham B31 1TP, UK
2Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, Bristol Road South, Northfield, Birmingham B31 2AP, UK

Received 2 November 2006; Accepted 30 October 2007

Academic Editor: Martin H. Robinson

Copyright © 2008 G. D. Johnson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.