title: Delay in treatment of primary malignant and aggressive musculoskeletal tumours.
abstract: Patients with aggressive musculoskeletal tumours often arrive at specialised treatment centres late. Such a delay could mean disfavour for potentially curable or long-term disease-free outcome of limb preserving surgery. This study was undertaken to identify the underlying problem-related delay with a view to propose solution for solving it. We reviewed 30 patients to determine the periods of delay between onset of the first symptom and the definitive treatment. The delays were categorized as 'patient' delay, 'referral' delay and 'treatment' delay. There was 'patient' delay in 57% of patients (n=17), ranging from 1 to 18 months; 'referral' delay in 67% of patients (n=20) ranging from 1 to 19 months and 23% of patients (n=7) had treatment delay (average 23 days) at the treatment centre. The causes of late arrival are not solely patient-related but are multifactorial. Measures to minimize such delays include enhancing awareness only with high index of suspicion among primary care practitioners, creating a special lane specialized imaging studies and establishing a dedicated musculoskeletal tumour unit.
authors.affiliation: Department of Orthopaedics, Universiti Malaysia Sarawak.
authors.forename: K L
authors.initials: KL
authors.lastname: Pan
authors.forename: A
authors.initials: A
authors.lastname: Zolqarnain
authors.forename: Y Y
authors.initials: YY
authors.lastname: Chia
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D023821:Limb Salvage; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011340:Problem Solving; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors