Szucs Zoltan, Davidson Dochka, Wong Han Hsi, Horan Gail, Bearcroft Philip W P, Grant Ian, Grimer Robert, Hopper Melanie A, Hatcher Helen, Earl Helena
Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
The Royal Orthopaedic Hospital NHS Foundation Trust and Sarcoma SAG, Bristol Road, South Birmingham B31 2AP, UK.
Sarcoma. 2016;2016:6032606. doi: 10.1155/2016/6032606. Epub 2016 Jun 2.
Background. National guidelines prompted the implementation of a designated two-week wait referral pathway to facilitate the early diagnosis of sarcomas, to improve treatment outcomes. Methods. Patients referred to the Cambridge Sarcoma Diagnostic Clinic between January 2013 and December 2014 were identified through the electronic appointments system. Information was retrospectively retrieved about patient characteristics and details of the diagnostic pathway. Results. 17.3% of patients referred (69/397) were diagnosed with a malignancy. Of these, 59.3% (41/69) had primary sarcomas, 17.4% (12/69) had metastatic cancer, and 23.2% (16/69) had a different primary malignancy. 15% of the 41 sarcomas were <5 cm, 34% in the 5-10 cm range, and 51% >10 cm. Sarcomas diagnosed through this clinic represented 13% (41/315) of sarcomas managed at the centre during the same 2 years. Conclusion. While we achieved the target of 10% (41/397) sarcoma diagnosis rate in the rapid access clinic, only 15% of these were <5 cm better prognosis lesions. This calls into question the "real world" impact of such diagnostic clinics on early diagnosis of sarcomas. In order to enhance generic cancer diagnostic skills, training in these diagnostic clinics could be usefully integrated into national training curricula for both surgical and nonsurgical oncologists.
背景。国家指南促使实施了指定的两周等待转诊途径，以促进肉瘤的早期诊断，改善治疗结果。方法。通过电子预约系统识别出2013年1月至2014年12月期间转诊至剑桥肉瘤诊断诊所的患者。回顾性收集患者特征和诊断途径的详细信息。结果。转诊患者中有17.3%（69/397）被诊断为恶性肿瘤。其中，59.3%（41/69）患有原发性肉瘤，17.4%（12/69）患有转移性癌症，23.2%（16/69）患有其他原发性恶性肿瘤。41例肉瘤中，15%小于5厘米，34%在5至10厘米范围内，51%大于10厘米。通过该诊所诊断的肉瘤占同一两年内在该中心治疗的肉瘤的13%（41/315）。结论。虽然我们在快速通道诊所实现了10%（41/397）的肉瘤诊断率目标，但其中只有15%是预后较好的小于5厘米的病变。这让人质疑此类诊断诊所在肉瘤早期诊断方面的“现实世界”影响。为了提高一般癌症诊断技能，这些诊断诊所的培训可以有效地纳入外科和非外科肿瘤学家的国家培训课程。
