Determinants and impact of diagnostic interval in bone sarcomas: A retrospective cohort study

被引：9

作者：

Sasi, Archana ^{[1
]}

Ganguly, Shuvadeep ^{[1
]}

Biswas, Bivas ^{[2
]}

Pushpam, Deepam ^{[1
]}

Kumar, Akash ^{[3
]}

Agarwala, Sandeep ^{[4
]}

Khan, Shah Alam ^{[5
]}

Kumar, Venkatesan Sampath ^{[5
]}

Deo, Suryanarayana ^{[6
]}

Sharma, Daya Nand ^{[7
]}

Bakhshi, Sameer ^{[1
,8
]}

机构：

[1] All India Inst Med Sci, Dept Med Oncol, BRA Inst Rotary Canc Hosp, New Delhi, India

[2] Tata Med Ctr, Dept Med Oncol, Kolkata, West Bengal, India

[3] All India Inst Med Sci, Natl Canc Inst, Dept Med Oncol, New Delhi, India

[4] All India Inst Med Sci, Dept Paediat Surg, New Delhi, India

[5] All India Inst Med Sci, Dept Orthopaed, New Delhi, India

[6] All India Inst Med Sci, Dept Surg Oncol, Dr BRA Inst Rotary Canc Hosp, New Delhi, India

[7] All India Inst Med Sci, Dept Radiat Oncol, Dr BRA Inst Rotary Canc Hosp, New Delhi, India

[8] All India Inst Med Sci, Dept Med Oncol, Dr BRA Inst Rotary Canc Hosp, New Delhi 110029, India

来源：

PEDIATRIC BLOOD & CANCER | 2023年 / 70卷 / 03期

关键词：

bone sarcoma; diagnostic interval; Ewing sarcoma; osteosarcoma; primitive neuroectodermal tumour; time to diagnosis; SINGLE INSTITUTIONAL EXPERIENCE; HIGH-GRADE OSTEOSARCOMA; PROGNOSTIC-FACTORS; EWINGS-SARCOMA; TUMORS; CHEMOTHERAPY; SURVIVAL; FAMILY; DELAY; EXTREMITIES;

D O I：

10.1002/pbc.30135

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundDiagnostic delays in cancers are frequent in developing countries due to poor health infrastructure. Existing literature from developed countries suggests that diagnostic interval in bone sarcomas is primarily dictated by tumour biology with no impact on survival. This study evaluates the social and biological determinants of the diagnostic interval in bone sarcomas in a resource-challenged setting and assesses its impact on treatment outcomes. MethodsA retrospective single-institutional study was conducted on patients with high-grade bone sarcomas recorded in the sarcoma clinic database between 2003 and 2018. Baseline clinical characteristics and treatment outcomes were recorded. Logistic regression was performed to assess the impact of baseline clinical and social characteristics (distance from treating centre and rural vs. urban residence) on the diagnostic interval. Further, the impact of diagnostic interval on histologic response to neoadjuvant chemotherapy, amputation requirement in extremity sarcomas and survival was evaluated. ResultsA total of 1227 patients were included for analysis. The median diagnostic interval was 4 months (3-7 months). Age above 18 years, Ewing sarcoma (ES) diagnosis, absence of fever at presentation and tumour size above 7.5 cm were predictors of a longer diagnostic interval (>4 months). The length of the diagnostic interval did not impact amputation requirement or survival outcomes. However, the proportion of patients with good necrosis post-neoadjuvant chemotherapy was lower among patients with longer diagnostic intervals (25% vs. 34 center dot 16%; p-value = .04). ConclusionTumour characteristics rather than social factors determined the diagnostic interval. Diagnostic interval did not impact survival outcomes even in a resource-constrained setting.

引用

页数：12