If your lump is bigger than a golf ball and growing, think Sarcoma. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Nandra, R.; Forsberg, J.; Grimer, R.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 10(2015:Oct.)
• Page Start: 1400
• Page End: 1405
• Publication Date: 2015-10
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2015.05.017
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Aim</title> <p id="abspara0010">Only 1 in 100 of primary care consultations regarding new soft tissue lumps (STL) are malignant and are susceptible to a delay in diagnosis. We aimed to generate a Bayesian Belief Network to estimate the likelihood of malignancy in patients to facilitate the initial evaluation of a STL and improve timing and quality of referrals to specialist treatment centres.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">We evaluated all patients referred with a new STL between 1996 and 2007. Variables investigated focused on patient factors, symptoms and STL characteristics. Relevant data was extracted and coded for statistical analysis.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">3018 patients with a STL were assessed, of which 1563 (52%) were benign and 1455 (48%) malignant. The features most conditionally associated with the outcome of interest (Benign or Malignant) are referred to as first-degree associates, and are increasing size, age, size of the lump, and duration of symptoms, in that order. On cross validation, this model demonstrated an AUC of 0.77 (95%C.I. 0.75–0.79).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">For the first time, we have described the hierarchal relationship between factors and created an aide memoire, larger than a golf ball and growing, to trigger referral to tertiary tumor units. Importantly, we found pain to be a poor discriminatory factor. We hope our findings will lead to greater awareness and earlier diagnosis of STL.</p> </sec> </abstract>