ArticleAnnals of the Royal College of Surgeons of England2015
Evaluating the British sarcoma referral form.
Article in Annals of the Royal College of Surgeons of England, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Diagnostic Delay in Soft Tissue Sarcomas: A Review.Cancers · 2025Review
- Review
- Assessment of medical students' knowledge of primary limb sarcomas.BMC medical education · 2024Article
- [Principles of sarcoma surgery].Der Pathologe · 2019Review
- [Systematic planning of surgery for soft tissue sarcoma of the extremities].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019Review
- Diagnosis and treatment of soft-tissue sarcomas of the extremities and trunk.EFORT open reviews · 2017Article
- Imaging investigations before referral to a sarcoma center delay the final diagnosis of musculoskeletal sarcoma.Acta orthopaedica · 2017Article
- Routes to Diagnosis for Suspected Sarcoma: The Impact of Symptoms and Clinical Findings on the Diagnostic Process.Sarcoma · 2016Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study investigated the accuracy of general practitioner (GP) referrals under the two-week wait pathway for soft tissue sarcomas and whether the current National Institute for Health and Care Excellence criteria should be refined.
methodsAll patients referred under the two-week wait system to one centre over the course of one year were reviewed. Comparison was made between the criteria identified by the GP and those confirmed by the centre to assess the accuracy of the referrals, and to identify what criteria predicted malignancy.
resultsOverall, 135 patients were referred to our unit with a mean age of 56.4 years. Of these, 45 (33%) were found to have a malignant tumour. Factors identified by the GP were accurate in 74% of cases. The best predictor of malignancy was 'size >5cm' (76% sensitivity) while 'pain' was the least useful (27% sensitivity). Lowering the threshold for concern to a size of >4cm increased sensitivity to 89%. Although 106 patients had undergone some form of imaging prior to referral, this did not increase the likelihood of malignancy being detected. The combination of factors most likely to predict malignancy was a size of >5cm, increase in size, deep location and no pain (10 out of 13 referrals, 77% accuracy).
conclusionsBased on the results of this study, we recommend an adaption of the existing features for concern. The new feature for concern should be 'size >4cm' and the factor 'pain' should be removed from the urgent referral form.
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