Cysteine proteinases in chondrosarcomas.

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Abstract

[Indexed for MEDLINE] 20. Ortop Traumatol Rehabil. 2023 Feb 28;25(1):9-22. doi: 10.5604/01.3001.0053.4026. Delay in Diagnosis and Treatment of Primary Bone Tumors. Kotrych D(1), Ciechanowicz D(2), Pawlik J(2), Brodecki A(2), Białomyzy A(2), Prowans P(3), Bohatyrewicz A(2), Szostakowski B(4). Author information: (1)Klinika Ortopedii Dziecięcej i Onkologii Narządu Ruchu, Pomorski Uniwersytet Medyczny w Szczecinie, Polska / Department of Pediatric Orthopedics and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland. (2)Klinika Ortopedii, Traumatologii i Onkologii Narządu Ruchu, Pomorski Uniwersytet Medyczny w Szczecinie, Polska / Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Szczecin, Poland. (3)Klinika Chirurgii Plastycznej, Endokrynologicznej i Ogólnej, Pomorski Uniwersytet Medyczny w Szczecinie, Polska / Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University in Szczecin, Poland. (4)Klinika Nowotworów Tkanek Miękkich, Kości i Czerniaków Narodowego Instytutu Onkologii im. Marii Skłodowskiej-Curie w Warszawie, Polska / Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. BACKGROUND: Delay in the diagnosis and treatment of bone tumors continues to be a common problem. Prolonged diagnosis can significantly reduce the chances of successful treatment of the disease. Accordingly, the aim of this study was to assess the delay in the diagnosis of primary bone tumors, identify the most common symptoms and analyze the course of the diagnostic and therapeutic path. MATERIAL AND METHODS: Thirty-two (K=18; M=14) patients treated surgically for primary bone tumors were included in the retrospective study. Patient records were analyzed. Delay in diagnosis was defined as the time from the onset of symptoms to the initial diagnosis and referral to an orthopedic oncology center. RESULTS: The median delay in diagnosis was 7 (3-12) months. For tumors located in the pelvis, the delay was 10 months, compared to 5 months for the upper limb and 7 months for the lower limb (p=0.2312). The delay was 6 months In patients with osteosarcoma, and 8 months in chondrosarcoma patients (p=0.1786). At the first office visit, an x-ray was ordered in 19 cases (59.4%), of whom 9 patients (47.4%) were referred on to the oncology center. The most common symptoms were pain in the affected area (90.6%), limited mobility (28.1%) and pathological fracture (25%). After admission to an orthopedic department, a biopsy was performed after 5.5 (3-8.2) days. The histology results were ready after another 14 (8-18) days, and surgical treatment was performed after 95 (76-100) days. CONCLUSIONS: 1. Although patients show typical symptoms of bone tumors, only a small proportion are referred directly to an oncology center. After a primary bone tumor is suspected, further diagnostic and therapeutic activities proceed efficiently, in accordance with the current guidelines. DOI: 10.5604/01.3001.0053.4026