Objective: Background-Time to treatment initiation (TTI) is a quality control metric to improve patient outcomes. Prolonged TTI negatively impacts survival in primary extremity sarcoma (PES).
Objectives- To quantify the TTI in PES and identify factors affecting TTI.
Methods: Retrospective study in patients with PES who received definitive treatment at our Institute from 2014 to 2018. Various parameters like tumor, treatment, socioeconomic, and healthcare system characteristics were collected and analyzed using T-test, Kruskal–Wallis, and Cox regression model.
Results: Median and mean TTI in bone sarcoma was 34 and 41.81 days while in soft tissue sarcoma it was 30 and 37.06 days respectively. Increased TTI was associated with grade ≥II tumor (IRR-1.28, P=0.001), gluteal (IRR-1.48, P-value-0.001), and upper extremity (IRR-1.33, P=0.015) as location. Age at diagnosis (10 years in bone sarcoma and >60 years in soft tissue sarcoma), leiomyosarcoma (IRR-0.87, P=0.045), females (IRR-0.87, P=0.045), thigh primary (IRR-0.74, P=0.001), and surgery as an initial treatment modality (IRR-0.814, 95% CI-0.75-0.88, P=0.001) significantly decreased TTI.
Conclusion: Causes of prolonged TTI are multifactorial. Primary site, grade, and non-surgical modality as index treatment significantly prolonged the TTI in extremity sarcoma. Identification of factors affecting TTI can lead to streamlining treatment, improving patient care, and may improve patient survival.
