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. 2023 Oct 9;15(19):4892.
doi: 10.3390/cancers15194892.

Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis

Maria Elyes  1 , Philip Heesen  2 , Georg Schelling  1 , Beata Bode-Lesniewska  3 , Gabriela Studer  1 , Bruno Fuchs  1   2   4 ; Swiss Sarcoma Network
Affiliations

Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis

Maria Elyes et al. Cancers (Basel). .

Abstract

Sarcomas, rare and with lower survival rates than common tumors, offer insights into healthcare efficiency via the analysis of the total interval of the diagnostic pathway, combining the patient interval (time between the first symptom and visit with a physician) and diagnostic interval (time between first physician visit and histological diagnosis). Switzerland's healthcare system, Europe's costliest, lacks research on treating rare conditions, like mesenchymal tumors. This study examines the total interval of the diagnostic pathway for optimization strategies. Analyzing a dataset of 1028 patients presented from 2018 to 2021 to the Swiss Sarcoma Board (MDT/SB-SSN), this retrospective analysis delves into bone sarcoma (BS), soft-tissue sarcoma (STS), and their benign counterparts. Demographic and treatment data were extracted from medical records. The patient interval accounted for the largest proportion of the total interval and secondary care interval for the largest proportion of the diagnostic interval. Age, grade, and localization could be elicited as influencing factors of the length of different components of the total interval. An increasing age and tumor size, as well as the axial localization, could be elicited as factors increasing the probability of sarcoma. The patient and secondary care interval (SCI) offer the greatest potential for optimization, with SCI being the bottleneck of the diagnostic interval. New organizational structures for care work-ups are needed, such as integrated practice units (IPU) as integral part of value-based healthcare (VBHC).

Keywords: MDT/SB-SSN; RWTD/E; benign bone tumor; benign soft-tissue tumor; diagnostic interval; healthcare system; multidisciplinary Team/Sarcoma Board of the Swiss Sarcoma Network; quality management system; real-world-time data evidence; referral patterns; sarcoma; total interval of diagnostic pathway.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the patient inclusion progress.
Figure 2
Figure 2
Time intervals from first symptom to the visit to a sarcoma center. Adopted from Soomers et al. 2020 [6]. Patient interval: time between date of first symptom and first visit to a physician. Primary care interval: time between first physician visit and first secondary referral to a specialized physician. Secondary care interval: time between first secondary referral and referral to a specialist sarcoma center. Tertiary care interval: time between referral to a specialist sarcoma center and the date of histological diagnosis. Diagnostic interval: time between first physician visit and histological diagnosis. Total interval of the diagnostic pathway (TIDP): time from first symptom to histological diagnosis.
Figure 3
Figure 3
Referral pattern of bone sarcoma, superficial soft-tissue sarcoma, and deep soft-tissue sarcoma.
Figure 4
Figure 4
Referral pattern of benign bone tumors, benign superficial soft-tissue tumors, and benign deep soft-tissue tumors.
See this image and copyright information in PMC

References

    1. OECD . OECD Health at a Glance 2021: OECD Indicators. OECD; Paris, France: 2021.
    1. Stiller C.A., Trama A., Serraino D., Rossi S., Navarro C., Chirlaque M.D., Casali P.G., RARECARE Working Group Descriptive epidemiology of sarcomas in Europe: Report from the RARECARE project. Eur. J. Cancer. 2013;49:684–695. doi: 10.1016/j.ejca.2012.09.011. - DOI - PubMed
    1. Kollár A., Rothermundt C., Klenke F., Bode B., Baumhoer D., Arndt V., Feller A. Incidence, mortality, and survival trends of soft tissue and bone sarcoma in Switzerland between 1996 and 2015. Cancer Epidemiol. 2019;63:101596. doi: 10.1016/j.canep.2019.101596. - DOI - PubMed
    1. Choi J.H., Ro J.Y. The 2020 WHO Classification of Tumors of Soft Tissue: Selected Changes and New Entities. Adv. Anat. Pathol. 2020;28:44–58. doi: 10.1097/PAP.0000000000000284. - DOI - PubMed
    1. Gatta G., Capocaccia R., Botta L., Mallone S., De Angelis R., Ardanaz E., Comber H., Dimitrova N., Leinonen M.K., Siesling S., et al. Burden and centralised treatment in Europe of rare tumours: Results of RARECAREnet—A population-based study. Lancet Oncol. 2017;18:1022–1039. doi: 10.1016/S1470-2045(17)30445-X. - DOI - PubMed

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