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The symptom interval in children and adolescents with soft tissue sarcomas
Article first published online: 27 OCT 2009
Copyright © 2010 American Cancer Society
Volume 116, Issue 1, pages 177–183, 1 January 2010
How to Cite
Ferrari, A., Miceli, R., Casanova, M., Meazza, C., Favini, F., Luksch, R., Catania, S., Fiore, M., Morosi, C. and Mariani, L. (2010), The symptom interval in children and adolescents with soft tissue sarcomas. Cancer, 116: 177–183. doi: 10.1002/cncr.24695
- Issue published online: 11 JAN 2010
- Article first published online: 27 OCT 2009
- Manuscript Accepted: 20 APR 2009
- Manuscript Revised: 12 MAR 2009
- Manuscript Received: 7 JAN 2009
- pediatric cancer;
- soft tissue sarcoma;
- symptom interval;
- prognostic factors;
In a series of 575 patients ≤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).
The analysis was based on multivariate models (linear for associations with patient/tumor characteristics and Cox's for survival).
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.
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. Cancer 2010. © 2010 American Cancer Society.