title: Association of short duration from initial symptoms to specialist consultation with poor survival in soft-tissue sarcomas.
abstract: BACKGROUND
  The association of symptom duration with survival remains controversial in soft-tissue sarcoma (STS).
  
  
  METHODS
  We determined whether the length from initial symptoms to specialist consultation affects prognosis in STSs. We retrospectively reviewed 152 primary STS patients (with 142 non-small round cell sarcomas) who consulted our specialist hospital. The factors that affected the length of the period from the initial symptoms to specialist consultation and the length of the delay at the clinic before specialist hospital referral were investigated. The relation between the length of the period from symptom onset and overall survival was also analyzed.
  
  
  RESULTS
  Unplanned excision and superficial tumor were significantly associated with increasing duration from the initial symptoms to specialist hospital referral. Multivariate analysis revealed that tumors over 5 cm (P=0.002 and 0.005) and symptoms within 6 months (P=0.017 and 0.016) were independent poor prognostic factors of overall survival among the pretreatment factors when analyzing all and non-small round cell STSs.
  
  
  CONCLUSIONS
  This is a first report to show the independent prognostic role of symptom duration in STSs on multivariate analysis. Considering the impact of symptom duration on survival in these heterogenous tumors, careful follow-up and consideration of treatment are necessary for patients with short symptom duration.
authors: Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi, Japan.
authors: Hiroshi
authors: H
authors: Urakawa
authors: Satoshi
authors: S
authors: Tsukushi
authors: Eisuke
authors: E
authors: Arai
authors: Eiji
authors: E
authors: Kozawa
authors: Naohisa
authors: N
authors: Futamura
authors: Naoki
authors: N
authors: Ishiguro
authors: Yoshihiro
authors: Y
authors: Nishida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D061665:Time-to-Treatment; D047368:Tumor Burden; D055815:Young Adult