Size matters for sarcomas!

INTRODUCTION By the time of diagnosis, sarcomas have frequently reached a large size and many patients have along history of symptoms prior to diagnosis. The aim of this study was to assess whether size of tumour at presentation or duration of symptoms was a significant factor affecting outcome. PATIENTS AND METHODS A prospective database recording patient, tumour, treatment and outcome factors was reviewed. A total of 1460 patients with newly diagnosed sarcomas and with > 3 years of follow-up were included for analysis. RESULTS The mean size of sarcomas presenting to our unit was 10.7 cm at the time of diagnosis. Bone sarcomas averaged 11.3 cm with little variation by age or diagnosis, whilst subcutaneous soft tissue sarcomas averaged 10 cm. The incidence of metastases at diagnosis increased almost linearly with increasing size and the prognosis, even for patients without metastases at diagnosis became steadily worse with increasing size for all tumours, independent of other factors. Duration of symptoms did not correlate with size but patients with symptoms > 1 year had a slightly better prognosis than those with a shorter duration. CONCLUSIONS The author makes a plea for greater awareness of potential malignancy in lumps and bumps, particularly those over the size of a golf ball (4.27 cm), making the point that the smaller the tumour at diagnosis the better the prognosis.