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General Orthopaedics

A review of the pattern of referrals for soft tissue sarcomas in the Mersey region

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Aim

The aim of this study was to review the referral pattern of Soft Tissue Sarcoma (STS) in the Mersey region. We were interested in the referrals that came from other specialties [not primary care] and how they were managed before being finally referred on to the Tumour Unit.

Methods

This was a retrospective review of 175 patients with a histological diagnosis of a STS. Case notes were reviewed and information was collected about the management by the first referred specialty doctor and the length of time to be referred to the specialist unit.

Results

Only 19 % of the patients (33/175) were direct referrals from primary care to the Tumour Unit. They were seen at a median time of 13 days (mean 17.2 days; range 1–89 days).

26% (45/175) had an unplanned excision at the hospital where they were initially seen. The median time from their first hospital appointment to the referral to the Tumour Unit was 61.5 days (mean 109.5 days; range 22–667 days).

55% (97/175) were referred from another hospital without definitive management. The median time from their first hospital appointment to the referral to the Tumour Unit was 24 days (mean 51.3 days; range 2–605 days).

Conclusion

In the Mersey region, most cases of STS are still being referred from other hospitals. 26% of the patients underwent unplanned excision and this group had the longest delay in presenting to the Tumour unit. The awareness of the NICE guidelines on Sarcoma referral needs to be improved at Primary and Secondary care settings in the Mersey region to avoid delayed referrals and unplanned excisions. Direct referrals to our unit are being seen within the recommended 14 days from referral.