肉瘤幸存者的患者和诊断间隔：来自 SURVSARC 研究的结果。

Patient and diagnostic intervals of survivors of sarcoma: Results from the SURVSARC study.

机构信息

Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

出版信息

Cancer. 2020 Dec 15;126(24):5283-5292. doi: 10.1002/cncr.33181. Epub 2020 Oct 1.

DOI:10.1002/cncr.33181

PMID:33002193

Abstract

BACKGROUND

Patients diagnosed with sarcoma are hypothesized to experience a prolonged route to a cancer diagnosis. This route, the total interval, can be divided into a patient interval (the time from the appearance of symptoms to physician consultation) and diagnostic interval (time from the first consultation to diagnosis). In the current study, the authors investigated these intervals among survivors of sarcoma and identified factors associated with prolonged intervals.

METHODS

A cross-sectional study was conducted among adult patients with sarcoma 2 to 10 years after diagnosis. Patients completed a questionnaire regarding their total interval, which was linked to clinical data from the Netherlands Cancer Registry. Descriptive statistics were used to describe intervals. Based on Dutch clinical guidelines, a diagnostic interval ≥1 month was considered to be prolonged and an interval ≥3 months was considered as very long. Multivariable regression analyses investigated associations between patient and tumor characteristics and interval length.

RESULTS

A total of 1099 participants were included (response rate, 58%); approximately 60% reported a patient interval ≥1 month and 36% reported a patient interval ≥3 months. Risk factors for a very long patient interval were sarcoma of the skin or pelvis, liposarcoma, or rhabdomyosarcoma. Stage III disease was associated with a shorter patient interval. The diagnostic interval length was ≥1 month in 55% of patients and ≥3 months in 28% of patients. Risk factors for a very long diagnostic interval were female sex, age <70 years, or having a synovial sarcoma or chordoma.

CONCLUSIONS

The patient and diagnostic interval lengths were prolonged in a substantial percentage of this sarcoma survivorship population. Factors found to be associated with the length of the patient interval or the diagnostic interval differed. Creating awareness among (especially young) patients to consult a physician and awareness among physicians to consider a sarcoma diagnosis will contribute to optimization of the total interval.

摘要

背景

患有肉瘤的患者被假设经历了一个延长的癌症诊断过程。这个过程，即总间隔，可以分为患者间隔（从症状出现到医生就诊的时间）和诊断间隔（从第一次就诊到诊断的时间）。在本研究中，作者调查了肉瘤幸存者的这些间隔，并确定了与延长间隔相关的因素。

方法

在诊断后 2 至 10 年的成年肉瘤患者中进行了一项横断面研究。患者完成了一份关于他们总间隔的问卷，该问卷与荷兰癌症登记处的临床数据相关联。使用描述性统计来描述间隔。根据荷兰临床指南，诊断间隔≥1 个月被认为是延长的，间隔≥3 个月被认为是非常长的。多变量回归分析调查了患者和肿瘤特征与间隔长度之间的关联。

结果

共纳入 1099 名参与者（应答率为 58%）；约 60%的患者报告患者间隔≥1 个月，36%的患者报告患者间隔≥3 个月。非常长的患者间隔的风险因素是皮肤或骨盆肉瘤、脂肪肉瘤或横纹肌肉瘤。III 期疾病与较短的患者间隔相关。55%的患者诊断间隔长度≥1 个月，28%的患者诊断间隔长度≥3 个月。非常长的诊断间隔的风险因素是女性、年龄<70 岁、患有滑膜肉瘤或脊索瘤。