Consequences of Delayed Diagnosis

  1. Vazquez-García, Blanca L. 3
  2. San-Julian, Mikel 1
  3. Patiño-García, Ana 4
  4. Sierrasesúmaga, Luis 4
  5. Taminiau, Antonie H. M. 2
  6. Dijkstra, P. D. Sander 2
  1. 1 Universidad de Navarra
    info

    Universidad de Navarra

    Pamplona, España

    ROR https://ror.org/02rxc7m23

  2. 2 Leiden University Medical Center
    info

    Leiden University Medical Center

    Leiden, Holanda

    ROR https://ror.org/05xvt9f17

  3. 3 Hospital Universitario de Navarra
    info

    Hospital Universitario de Navarra

    Pamplona, España

  4. 4 Clínica Universitaria de Navarra
    info

    Clínica Universitaria de Navarra

    Pamplona, España

    ROR https://ror.org/03phm3r45

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Libro:
Cañadell's Pediatric Bone Sarcomas

Editorial: Springer

ISBN: 978-3-319-24218-7,  978-3-319-24220-0

Año de publicación: 2016

Páginas: 139-146

Tipo: Capítulo de Libro

DOI: 10.1007/978-3-319-24220-0_8 GOOGLE SCHOLAR lock_openAcceso abierto editor

Resumen

Background: To determine for pediatric patients with high grade metaphyseal osteosarcoma whether there are any correlations between delay in diagnosis (time between appearance of symptoms and start of treatment), tumoral spread across physis and outcome. Procedure: The clinical records, imaging methods and histology reports of 157 patients with high grade metaphyseal pediatric osteosarcoma of a long bone were reviewed. The mean follow-up time was 102 months. Location, histological subtype, time from initial symptoms to start of treatment, major diameter, percentage of necrosis, whether the physis was crossed by the tumor, and outcome (recurrence, metastasis and status) were collated and statistically analyzed with SPSS v15.0. Results: Compared to the group of patients with unbreached physis, the group with tumors that had crossed the physis (58 % of patients) was older (13.4 vs 11.9 years; p = 0.05), had longer diagnostic delay (4 vs 2 months; p < 0.0001), had almost twice the incidence of metastasis at diagnosis (38 % vs 22 %, p = 0.043) and had poorer outcome (overall survival 49 % vs 67 %). Statistical analysis demonstrated an age-independent correlation between diagnostic delay and tumoral spread across the physis (p < 0.0001). Conclusion: Breach of the physis by a metaphyseal pediatric osteosarcoma is a matter of time. Outcomes for patients with tumors that had crossed the physis were worse than for patients with tumors that had not. Diagnostic delay of over 2 months was associated with poor prognosis. We urge that a major effort be undertaken to facilitate early diagnosis of all patients who might be suffering from this lesion.

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