[Delayed diagnosis of osteosarcoma in adults: a prognostic factor to be considered].

M A Clara-Altamirano, D Y García-Ortega, A Álvarez-Cano, S Velázquez-Rodríguez, A R Lizcano-Suárez, L C Rosas, C E Uribe-Saloma, H Martínez-Said, V Villavicencio-Valencia, M Cuellar-Hubbe
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Abstract

Introduction: different variables have been associated with a worse prognosis of patients with osteosarcoma (OS), highlighting tumor size, location in the axial skeleton and the presence of metastases. The objective of this study is to analyze the prognostic impact of diagnostic delay in osteosarcoma in adults in the Mexican population in a center specialized in sarcomas.

Material and methods: retrospective cohort study from January 1, 2005, to December 31, 2016, 96 patients over 21 years of age with a diagnosis of osteosarcoma were analyzed.

Results: the median time to diagnosis from the onset of symptoms was six months (range: 2-36). This variable was dichotomized by applying the operator-dependent curve (ROC) analysis and we determined a cut-off value greater than five months, with an area under the curve (AUC) = 0.93 [95% CI 0.86-0.97], sensitivity 93.2% and specificity 94.6%.

Conclusion: time until diagnosis is a critical factor in the survival of adult patients with osteosarcoma, highlighting its influence on disease progression and the appearance of metastasis. The correlation between diagnostic delay and an unfavorable prognosis reinforces the need for rapid and efficient evaluation in suspected cases of osteosarcoma.

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[成人骨肉瘤的延迟诊断:一个需要考虑的预后因素]。
导言:不同的变量与骨肉瘤(OS)患者的不良预后有关,其中突出的是肿瘤的大小、在轴性骨骼中的位置以及是否存在转移。本研究的目的是在一家肉瘤专科中心分析墨西哥成人骨肉瘤诊断延迟对预后的影响。材料与方法:2005年1月1日至2016年12月31日的回顾性队列研究,分析了96名年龄在21岁以上、诊断为骨肉瘤的患者。应用操作者依赖曲线(ROC)分析法对这一变量进行二分,我们确定了一个大于五个月的临界值,曲线下面积(AUC)= 0.93 [95% CI 0.86-0.97],灵敏度为 93.2%,特异度为 94.6%。结论:诊断前的时间是影响成年骨肉瘤患者生存的一个关键因素,突出了其对疾病进展和出现转移的影响。诊断延迟与预后不良之间的相关性加强了对骨肉瘤疑似病例进行快速有效评估的必要性。
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