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Peter Vedsted

Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center

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Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center. / Dyrop, Heidi B.; Vedsted, Peter; Safwat, Akmal; Maretty-Nielsen, Katja; Hansen, Bjarne H.; Jorgensen, Peter H.; Baad-Hansen, Thomas; Keller, Johnny.

I: Acta Orthopaedica, Bind 85, Nr. 6, 12.2014, s. 657-662.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{a0f216a3ec9d4522b47c823c90c31e80,
title = "Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center",
abstract = "Background and purpose -The Danish Cancer Patient Pathway for sarcoma defines a set of alarm symptoms as criteria for referral to a sarcoma center. This may exclude cancer patients without alarm symptoms, so we investigated the presence of alarm symptoms (defined as being indicative of a sarcoma) in patients who had been referred to the Aarhus Sarcoma Center. Patients and methods -We reviewed the medical records of all 1,126 patients who had been referred, with suspected sarcoma, from other hospitals in the period 2007-2010 for information on symptoms, clinical findings, and diagnosis. Alarm symptoms were analyzed for predictive values in diagnosing sarcoma.Results - 179 (69%) of 258 sarcoma patients were referred with alarm symptoms (soft-tissue tumor > 5 cm or deep-seated, fast-growing soft-tissue tumor, palpable bone tumor, or deep persisting bone pain). The remaining 79 sarcomas were found accidentally. {"} Size over 5 cm{"} for soft-tissue tumors, and {"} deep persisting bone pain{"} for bone tumors had the highest sensitivity and positive predictive value. Of the 79 sarcoma patients who were referred without alarm symptoms, 7 were found accidentally on imaging, 5 were referred with suspected recurrence of a sarcoma, 64 were referred with a confirmed histological diagnosis, and 3 were referred for other reasons.Interpretation - Defined alarm symptoms are predictive of sarcoma, but one-third of the patients were found accidentally. Further studies on presenting symptoms in primary care are needed to assess the true value of alarm symptoms.",
keywords = "GENERAL-PRACTICE, DIAGNOSIS, CANCER, DENMARK, GUIDELINES, MANAGEMENT, PATHWAYS, PATTERNS, CARE",
author = "Dyrop, {Heidi B.} and Peter Vedsted and Akmal Safwat and Katja Maretty-Nielsen and Hansen, {Bjarne H.} and Jorgensen, {Peter H.} and Thomas Baad-Hansen and Johnny Keller",
year = "2014",
month = dec,
doi = "10.3109/17453674.2014.957086",
language = "English",
volume = "85",
pages = "657--662",
journal = "Acta Orthopaedica (Print Edition)",
issn = "1745-3674",
publisher = "TAYLOR & FRANCIS LTD",
number = "6",

}

RIS

TY - JOUR

T1 - Alarm symptoms of soft-tissue and bone sarcoma in patients referred to a specialist center

AU - Dyrop, Heidi B.

AU - Vedsted, Peter

AU - Safwat, Akmal

AU - Maretty-Nielsen, Katja

AU - Hansen, Bjarne H.

AU - Jorgensen, Peter H.

AU - Baad-Hansen, Thomas

AU - Keller, Johnny

PY - 2014/12

Y1 - 2014/12

N2 - Background and purpose -The Danish Cancer Patient Pathway for sarcoma defines a set of alarm symptoms as criteria for referral to a sarcoma center. This may exclude cancer patients without alarm symptoms, so we investigated the presence of alarm symptoms (defined as being indicative of a sarcoma) in patients who had been referred to the Aarhus Sarcoma Center. Patients and methods -We reviewed the medical records of all 1,126 patients who had been referred, with suspected sarcoma, from other hospitals in the period 2007-2010 for information on symptoms, clinical findings, and diagnosis. Alarm symptoms were analyzed for predictive values in diagnosing sarcoma.Results - 179 (69%) of 258 sarcoma patients were referred with alarm symptoms (soft-tissue tumor > 5 cm or deep-seated, fast-growing soft-tissue tumor, palpable bone tumor, or deep persisting bone pain). The remaining 79 sarcomas were found accidentally. " Size over 5 cm" for soft-tissue tumors, and " deep persisting bone pain" for bone tumors had the highest sensitivity and positive predictive value. Of the 79 sarcoma patients who were referred without alarm symptoms, 7 were found accidentally on imaging, 5 were referred with suspected recurrence of a sarcoma, 64 were referred with a confirmed histological diagnosis, and 3 were referred for other reasons.Interpretation - Defined alarm symptoms are predictive of sarcoma, but one-third of the patients were found accidentally. Further studies on presenting symptoms in primary care are needed to assess the true value of alarm symptoms.

AB - Background and purpose -The Danish Cancer Patient Pathway for sarcoma defines a set of alarm symptoms as criteria for referral to a sarcoma center. This may exclude cancer patients without alarm symptoms, so we investigated the presence of alarm symptoms (defined as being indicative of a sarcoma) in patients who had been referred to the Aarhus Sarcoma Center. Patients and methods -We reviewed the medical records of all 1,126 patients who had been referred, with suspected sarcoma, from other hospitals in the period 2007-2010 for information on symptoms, clinical findings, and diagnosis. Alarm symptoms were analyzed for predictive values in diagnosing sarcoma.Results - 179 (69%) of 258 sarcoma patients were referred with alarm symptoms (soft-tissue tumor > 5 cm or deep-seated, fast-growing soft-tissue tumor, palpable bone tumor, or deep persisting bone pain). The remaining 79 sarcomas were found accidentally. " Size over 5 cm" for soft-tissue tumors, and " deep persisting bone pain" for bone tumors had the highest sensitivity and positive predictive value. Of the 79 sarcoma patients who were referred without alarm symptoms, 7 were found accidentally on imaging, 5 were referred with suspected recurrence of a sarcoma, 64 were referred with a confirmed histological diagnosis, and 3 were referred for other reasons.Interpretation - Defined alarm symptoms are predictive of sarcoma, but one-third of the patients were found accidentally. Further studies on presenting symptoms in primary care are needed to assess the true value of alarm symptoms.

KW - GENERAL-PRACTICE

KW - DIAGNOSIS

KW - CANCER

KW - DENMARK

KW - GUIDELINES

KW - MANAGEMENT

KW - PATHWAYS

KW - PATTERNS

KW - CARE

U2 - 10.3109/17453674.2014.957086

DO - 10.3109/17453674.2014.957086

M3 - Journal article

C2 - 25175662

VL - 85

SP - 657

EP - 662

JO - Acta Orthopaedica (Print Edition)

JF - Acta Orthopaedica (Print Edition)

SN - 1745-3674

IS - 6

ER -