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- Title
Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center.
- Authors
Dyrop, Heidi B; Vedsted, Peter; Safwat, Akmal; Maretty-Nielsen, Katja; Hansen, Bjarne H; Jørgensen, Peter H; Baad-Hansen, Thomas; Keller, Johnny
- Abstract
Background and purpose -- The Danish Cancer Patient Pathway for sarcoma defines a set of alarm symptoms as criteria for referral to a sarcoma center. This may exclude cancer patients without alarm symptoms, so we investigated the presence of alarm symptoms (defined as being indicative of a sarcoma) in patients who had been referred to the Aarhus Sarcoma Center. Patients and methods -- We reviewed the medical records of all 1,126 patients who had been referred, with suspected sarcoma, from other hospitals in the period 2007-2010 for information on symptoms, clinical findings, and diagnosis. Alarm symptoms were analyzed for predictive values in diagnosing sarcoma. Results -- 179 (69%) of 258 sarcoma patients were referred with alarm symptoms (soft-tissue tumor > 5 cm or deep-seated, fast-growing soft-tissue tumor, palpable bone tumor, or deep persisting bone pain). The remaining 79 sarcomas were found accidentally. "Size over 5 cm" for soft-tissue tumors, and "deep persisting bone pain" for bone tumors had the highest sensitivity and positive predictive value. Of the 79 sarcoma patients who were referred without alarm symptoms, 7 were found accidentally on imaging, 5 were referred with suspected recurrence of a sarcoma, 64 were referred with a confirmed histological diagnosis, and 3 were referred for other reasons. Interpretation -- Defined alarm symptoms are predictive of sarcoma, but one-third of the patients were found accidentally. Further studies on presenting symptoms in primary care are needed to assess the true value of alarm symptoms.
- Subjects
DENMARK; COMPUTED tomography; CONFIDENCE intervals; MAGNETIC resonance imaging; RESEARCH funding; SARCOMA; PREDICTIVE tests; SOFT tissue tumors; DATA analysis software; DESCRIPTIVE statistics; SYMPTOMS; DIAGNOSIS
- Publication
Acta Orthopaedica, 2014, Vol 85, Issue 6, p657
- ISSN
1745-3674
- Publication type
Article
- DOI
10.3109/17453674.2014.957086