IS DEATH WITHIN ONE YEAR AN INDICATOR OF DELAYS IN PRESENTATION FOR SARCOMAS

Background Death within one year has been shown for some cancers to be an indicator of late presentation. They may have widespread disease by the time of diagnosis and many will have experienced delays in diagnosis. The aim of this study is to identify if this holds true for patients with bone and soft tissue sarcomas. Method A prospective sarcoma database was used to identify all patients with a newly diagnosed bone or soft tissue sarcoma and to compare those who had died within one year with those who had survived for at least that time. Results 5633 patients were included in the analysis of whom 3039 had a bone sarcoma and 2593 a soft tissue sarcoma. 839 patients (15%) died within one year of diagnosis, of whom 430 had a bone sarcoma (14%) and 409 a soft tissue sarcoma (16%). Significant differences (p⋋0.0001) were seen with age, size and metastases at diagnosis for bone sarcomas and age, size, symptom duration, metastases at diagnosis, a previous whoops excision and superficial tumours for soft tissue sarcomas. Conclusion 15% of patients with a newly diagnosed sarcoma will be dead within one year. This appears to be associated with known poor prognostic factors (metastases at diagnosis, age and tumour size) and is not clearly associated with duration of symptoms. Whether it is a surrogate for delays in diagnosis has not been proved by this study.