The symptom interval in children and adolescents with soft tissue sarcomas.
BACKGROUND
In a series of 575 patients < or =21 years of age with soft tissue sarcomas (STSs), the authors investigated the association patterns between symptom interval (ie, the period between the onset of the first symptoms or signs of the disease and its definitive diagnosis) and patient/tumor characteristics or disease outcome (in terms of survival).


METHODS
The analysis was based on multivariate models (linear for associations with patient/tumor characteristics and Cox's for survival).


RESULTS
The symptom interval ranged between 1 week and 60 months (median, 2 months) and tended to be longer the older the patient (ie, the interval was longer in adolescents than in children) and the larger the tumor's size, and for tumors located at the extremities and for nonrhabdomyosarcoma STSs (as opposed to rhabdomyosarcomas). A longer symptom interval unfavorably influenced survival (P = .002), which was also significantly affected by the patient's age and the size and surgical stage of the tumor. A different pattern of association between symptom interval and survival emerged for different types of STS histology.


CONCLUSIONS
Our study points to an independent prognostic effect of symptom interval that cannot be explained by its associations with other factors, such as patient's age or the site, size, stage, and histology of the tumor. Future studies should focus more on the possible causes of symptom interval in pediatric STS populations to enable corrective measures to be implemented to reduce the diagnostic delay.
Pediatric Oncology Unit, National Tumor Institute, Milan, Italy. andrea.ferrari@istitutotumori.mi.it
Andrea
A
Ferrari
Rosalba
R
Miceli
Michela
M
Casanova
Cristina
C
Meazza
Francesca
F
Favini
Roberto
R
Luksch
Serena
S
Catania
Marco
M
Fiore
Carlo
C
Morosi
Luigi
L
Mariani
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012509:Sarcoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D013997:Time Factors