Delay in referral to a specialist soft-tissue sarcoma unit

Area of Science:

• Oncology
• Surgical Oncology
• Diagnostic Pathways

Background:

• Soft-tissue sarcoma (STS) is a rare malignancy with nonspecific symptoms, often mimicking other conditions.
• Delayed diagnosis and referral to specialist centers are frequent challenges in managing STS.
• The nonspecific nature of STS contributes to diagnostic delays.

Purpose of the Study:

• To audit the referral and diagnostic pathway for patients with suspected or confirmed soft-tissue sarcoma.
• To identify the incidence and causes of referral delays to a specialist sarcoma unit.
• To assess the impact of delays on patient management and outcomes.

Main Methods:

• Prospective audit of 216 patients referred to a specialist unit over 12 months.
• Patient interviews to map symptom onset, referral timelines, and diagnostic processes.
• Definition of referral delay as >= 3 months from first medical presentation to specialist review.

Main Results:

• 159 patients had previously untreated soft-tissue sarcomas.
• Thirty-one patients (20%) experienced referral delays, with a median delay of 14 months (range 4-96 months).
• Delays originated from general practitioners (13), patients post-GP referral (2), referring hospitals/specialists (7), or were multifactorial (9).

Conclusions:

• A significant proportion (one-fifth) of soft-tissue sarcoma patients face substantial referral delays.
• These delays likely compromise treatment options and patient outcomes, potentially affecting survival.
• Improving diagnostic pathways and reducing referral times are crucial for optimal STS management.