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· DOS Abstracts
Tumor characteristics, patient reported symptoms
and suspected and final diagnosis for 64 sarcoma
patients referred to a sarcoma center after surgery/
biopsy in non-specialist institutions.
Heidi Buvarp Dyrop, Peter Vedsted, Katja Maretty-Nielsen,
Bjarne Hauge Hansen, Peter Holmberg Jørgensen, Johnny Keller
Department of Experimental Clinical Oncology, Aarhus University Hospital;
The Research Unit for General Practice, Aarhus University; Department of
Orthopaedics, Sarcoma Centre of Aarhus University Hospital
Background:
Some sarcomas are referred after surgery on suspected be-
nign tumors. This can affect patient prognosis and cause large re- excisions.
Knowledge about diagnostic pathways of these patients is uncertain and must
be reviewed.
Purpose / Aim of Study:
To investigate patient and tumor characteristics,
patient reported symptoms, suspected and final diagnosis, and explore reasons
for referral, in sarcoma patients referred after surgery in non-specialist institu-
tions.
Materials and Methods:
Retrospective review of medical files. From a pre-
vious study on 258 sarcoma patients referred over 4 years, we identified 64
(24.8%) referred with a confirmed histological sarcoma. Medical files were re-
viewed for patient reported symptoms, suspected diagnosis and reasons for
referral. Patient and tumor characteristics were previously collected.
Findings / Results:
27 (42.2 %) tumors were low grade, 37 (57.8 %) high
grade. Lipoma and fibroma/dermatofibroma were most reported suspected
diagnoses. 7 patients were suspected of other malignancies due to location
(breast, testicles, kidney). For 23 (35.9%) patients, initial presence of alarm
symptoms were described in the referral text. 9 tumors were >5cm, 10 sub-
fascial and 9 were both. 32 (50%) had superficial small tumors, of which 21
(65.6%) were suspected skin conditions. 8 (12.5%) of 64 patients stated that it
was a second removal of a tumor in the same area. 3 patients reported changes
in a tumor that had been present for years.
Conclusions:
1/4 of sarcoma patients had surgery on suspected benign tu-
mors. For 1/3, alarm symptoms had been reported, the remaining fell outside
referral guidelines or alarm symptoms were not discovered. Sarcoma should be
considered even in unusual or superficial locations, also when the tumor is <5
cm. Recurring benign tumors and changes in dormant tumors should cause re-
evaluation of diagnosis.
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