Abstract
Introduction
Benign lesions in bone are less studied in terms of progression and prognosis. There is presently no literature studying symptom interval (SI) in neoplastic bone lesions or determinants of delay in Indian setting. The literature is also sparse on SI in benign lesions of bone, since benign bone lesions have seemingly less menacing symptoms and slow progression as compared to their malignant counterparts. Social and cultural issues peculiar to the region of study have an impact on the symptom interval of benign bony lesions.
Method
A prospective, observational study was conducted at a tertiary level University teaching hospital from December 2017 to August 2019. The study included 55 patients presenting with benign cystic lesions of bone. Appropriate radiological investigations along with tissue biopsy were done. All the patients were enquired as per a preformed questionnaire to determine the delay and its determinants.
Result
Out of the 55 patients included in the study, wide variety of cystic lesions was observed with varied presentation and delay. Median SI of 175 days (range 27–3705 days) was observed in the present study. However, it was found that longer SI did not have a statistically significant effect on the type of procedure done (p = 0.206) though diagnostic delay was significantly related to the intervention required (p = 0.004). It was observed that tumor behavior at the time of presentation such as histopathological diagnosis (p = 0.000), presence of cortical breach (p = 0.001), stage of tumor (0.001), and articular involvement (p = 0.000) remained as some of the most important factors in determining the prognosis and outcome in case of benign cystic lesions of bone.
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References
Camargo, O. P., & Croci, A. T. (1999). Diagnostico e tratamento dos sarcoma osseos de altamalignidade. A Revista Diagnóstico & Tratamento, 4, 20–25.
Eyesan, S. U. (2011). Surgical consideration for benign bone tumors. Nigerian Journal of Clinical Practice, 14(2), 146–150.
Wurtz, L. D., Peabody, T. D., & Simon, M. A. (1999). Delay in the diagnosis and treatment of primary bone sarcoma of the pelvis. Journal of Bone and Joint Surgery. American Volume, 81, 317–325. https://doi.org/10.1302/0301-620X.81B2.8979.
Dwivedi, K. A. (2012). An epidemiological study on delay in treatment initiation of cancer patients. Health, 42, 66–79.
Sneppen, O., & Hansen, L. M. (1984). Presenting symptoms and treatment delay in osteosarcoma and Ewing's sarcoma. Acta Radiologica: Oncology, 23, 159–162. https://doi.org/10.3109/02841868409136005.
Clark, M. A., & Thomas, J. M. (2005). Delay in referral to a specialist soft-tissue sarcoma unit. European Journal of Surgical Oncology, 31(4), 443–448.
Pan, K. L., Zolqarnain, A., & Chia, Y. Y. (2006). Delay in treatment of primary malignant and aggressive musculoskeletal tumours. Medical Journal of Malaysia, 61(Suppl), 53–6.
Schnurr, C., Pippan, M., Stuetzer, H., Delank, K. S., Michael, W. P., & Eysel, P. (2008). Treatment delay of bone tumours, compilation of a sociodemographic risk profile: A retrospective study. BMC Cancer, 8, 22.
Yang, J. Y., Cheng, F. W., Wong, K. C., Lee, V., Leung, W. K., Shing, M. M., et al. (2009). Initial presentation and management of osteosarcoma, and its impact on disease outcome. Hong Kong Medical Journal, 15(6), 434–439.
Balmant, N. V., Silva, N. D. P., Santos, M. D. O., Reis, R. D. S., & Camargo, B. D. (2019). Delays in the health care system for children, adolescents, and young adults with bone tumors in Brazil. Jornal de Pediatria (Rio J). https://doi.org/10.1016/j.jped.2018.07.003.
Lawrenz, J. M., Styron, J. F., Parry, M., Grimer, R. J., & Mesko, N. W. (2018). Longer duration of symptoms at the time of presentation is not associated with worse survival in primary bone sarcoma. The Bone Joint Journal, 100, 652–61.
Chen, C. P., Kung, P. T., Wang, Y. H., & Tsai, W. C. (2019). Effect of time interval from diagnosis to treatment for cervical cancer on survival: A nationwide cohort study. PLoS One, 14(9), e0221946.
Mariella, M., Kimbrough, C. W., McMasters, K. M., & Ajkay, N. (2018). Longer Time intervals from diagnosis to surgical treatment in breast cancer: Associated factors and survival impact. Am Surg, 84(1), 63–70.
Tsai, W. C., Kung, P. T., Wang, Y. H., Kuo, W. Y., & Li, Y. H. (2018). Influence from the time interval from diagnosis to treatment on survival for early stage liver cancer. Plos One, 13(6), e0199532.
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Jain, A., Barik, S., Kalia, R. et al. Symptom Interval in Cases of Benign Cystic Lesions of Bone and its correlation with Surgical Intervention. JOIO 55 (Suppl 1), 241–245 (2021). https://doi.org/10.1007/s43465-020-00131-5
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DOI: https://doi.org/10.1007/s43465-020-00131-5