title: Delay in referral to a specialist soft-tissue sarcoma unit.
abstract: BACKGROUND
  Soft-tissue sarcoma is a rare neoplasm which can occur almost anywhere in the body. There are no specific symptoms and signs and the disease can mimic more common benign and malignant conditions. It is not surprising, therefore, that diagnosis and referral to a specialist unit is often delayed.
  
  
  METHODS
  A prospective audit was undertaken in 216 patients referred to a specialist unit with suspected or proven soft-tissue sarcoma over a 12 month period. All patients were interviewed to determine the chronology of symptoms and signs, and the referral and diagnostic pathway. Delay in referral was defined as three months or greater from first presentation to a doctor to review at our unit.
  
  
  RESULTS
  There were 159 patients with previously untreated soft-tissue sarcomas. Thirty-one patients had delays in referral, and the overall median delay was 14 months (range 4-96 months). The delay was caused by the general practitioner in 13 patients, the patient (after general practitioner referral) on two occasions, by the hospital or referring specialist in seven patients, and was multifactorial in nine patients.
  
  
  CONCLUSIONS
  A fifth of patients with soft-tissue sarcoma encountered important delays in referral to this specialist unit. This duration of delay is likely to have had a detrimental effect on treatment options and outcomes, including survival in some patients.
authors.affiliation: Department of Surgery, Melanoma and Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Road, Chelsea, London SW3 6JJ, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Clark
authors.forename: J M
authors.initials: JM
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012509:Sarcoma / Q000175:diagnosis*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis*; D013997:Time Factors