title: [Health care circuit for patients with soft tissue sarcomas of the extremities. A tortuous and slow road to referral units].
abstract: OBJECTIVE
  To analyse the waiting periods elapsed since soft tissue sarcomas become symptomatic until their specific treatment in our unit, and to determine new strategies for the improvement of referral circuits.
  
  
  METHODS
  This is an ambispective observational study of a cohort of 61 patients, with previously untreated soft tissue sarcomas, obtained from our Musculoskeletal Tumors Database. Several variables related to the patient, tumour, and health care circuit were analysed, as well as the different periods between the initial symptoms of the disease and the first consultation in our unit. The significance level was α=0.05.
  
  
  RESULTS
  The mean size of the sarcomas was 11.3 cm. Thirty-six patients (59%) followed the usual circuit of the National Health System in Spain. The time elapsed since the disease became symptomatic until the first medical consultation was greater than 9.5 months, and nearly another 8.5 months to the consultation in our specific unit. Statistically significant relationships were found between the independent and dependent variables.
  
  
  CONCLUSIONS
  The study shows that the care of patients with soft tissue sarcomas in our environment is far away from the times of care in our neighbouring countries.
  
  
  CONCLUSIONS
  It is essential to make the population and health professionals aware of this disease, as well as to remember that there is a referral circuit that must be used.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España. Electronic address: luisramospascua@gmail.com.
authors.forename: L R
authors.initials: LR
authors.lastname: Ramos-Pascua
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: S
authors.initials: S
authors.lastname: Sánchez-Herráez
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: P
authors.initials: P
authors.lastname: Casas-Ramos
authors.affiliation: Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Izquierdo-García
authors.affiliation: Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Red de Investigación de Actividades Preventivas y Promoción de la Salud (RedIAPP), Salamanca, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Maderuelo-Fernández
mesh_terms: D000368:Aged; D057210:Delayed Diagnosis; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors
keywords: Centro de referencia; Delayed diagnosis; Demora; Derivación; Referral; Referral centre; Sarcoma de partes blandas; Soft tissue sarcoma