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Does Length of Symptoms Before Diagnosis of Sarcoma Affect Patient Survival?

It generally is accepted that earlier diagnosis of sarcoma is associated with a better disease-free survival. Because the legal community is convinced this is true, a delay in cancer diagnosis is a frequent source of medical malpractice lawsuits. We asked whether symptom duration before diagnosis affected sarcoma outcome. We compiled prospective data from 624 consecutive patients with sarcoma treated from 1992 to 2003. The data included length of symptoms before diagnosis, tumor size and grade, presence of metastatic disease at diagnosis, anatomic location, disease-free survival, overall survival, and local recurrence. Length of symptoms did not predict presence of metastatic disease at diagnosis, survival, or disease-free survival. We found no correlation between the length of a patient's symptoms and the tumor size or anatomic site of disease (axial, proximal, and distal). Tumors were larger at diagnosis in axial and proximal locations than in more peripheral locations, despite no difference in length of symptoms before diagnosis. Patients with sarcoma with long-standing symptoms did not have a worse prognosis than those with a shorter length of symptoms before diagnosis in terms of disease-free survival, overall survival, and presence of metastatic disease at diagnosis. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.