Fernández Juan Ángel, Gómez Beatriz, Díaz-Gómez Daniel, López Irene, Lozano Pablo, Muñoz Paula, Muñoz-Casares Francisco Cristóbal, Olivares-Ripoll Vicente, Vasques Hugo, Asencio-Pascual José Manuel
Department of General Surgery, Hospital Universitario Los Arcos del Mar Menor, 30739 Murcia, Spain.
Campus de los Jerónimos, Universidad Católica de Murcia UCAM, 30107 Murcia, Spain.
Cancers (Basel). 2025 May 31;17(11):1861. doi: 10.3390/cancers17111861.
BACKGROUND/OBJECTIVES: To review the problem of diagnostic delay in soft tissue sarcomas with the aim of identifying its causes and consequences, understanding how to clinically suspect and refer them, and evaluating the main limitations of the referral guidelines already in use.
A systematic review of the available literature was performed, focusing on the theoretical framework, the elements and time intervals to be considered, causes and consequences, "red flag" symptoms/signs, the main referral guidelines in use, their results, and the methods used to avoid excessive referrals.
Diagnostic delay in soft tissue sarcomas is a frequent event that is poorly characterized and has important consequences, including prognostic, medico-legal and psycho-social effects. The common denominator is the lack of knowledge and awareness. Several referral guidelines have been described, and most of them are based on clinical data. Their results have been disappointing. Thus, it is necessary to implement new methods to improve their results and avoid the overload of pre-referral imaging systems, sarcoma diagnostic triage meetings, and telemedicine systems.
Sarcoma units and health system leaders need to study this issue to determine the extent of the problem and its causes. Without this information, it is almost impossible to properly address the problem and take corrective actions. Early referral of suspected soft tissue sarcoma lesions, although desirable, is a complex issue due to the non-specificity of the symptoms. Existing clinical referral guidelines need to be modified to improve detection and conversion rates.
背景/目的：回顾软组织肉瘤诊断延迟的问题，旨在确定其原因和后果，了解如何在临床上怀疑并转诊此类疾病，以及评估现行转诊指南的主要局限性。
对现有文献进行系统综述，重点关注理论框架、需考虑的因素和时间间隔、原因和后果、“红旗”症状/体征、现行主要转诊指南、其结果以及用于避免过度转诊的方法。
软组织肉瘤的诊断延迟是常见现象，其特征描述不足且具有重要后果，包括对预后、医疗法律及心理社会方面的影响。共同问题是缺乏知识和认识。已描述了几种转诊指南，其中大多数基于临床数据。其结果并不理想。因此，有必要采用新方法来改善结果，并避免转诊前成像系统、肉瘤诊断分诊会议和远程医疗系统的负担过重。
肉瘤科室和卫生系统负责人需要研究此问题，以确定问题的严重程度及其原因。没有这些信息，几乎不可能妥善解决问题并采取纠正措施。尽管早期转诊疑似软组织肉瘤病变是理想的，但由于症状不具特异性，这是一个复杂的问题。需要修改现有的临床转诊指南，以提高检出率和转化率。
