An Audit of Delays in the Management of Non-Metastatic Osteosarcoma at a Tertiary Care Center in South India.

Abstract

Background and objectiveDelays in the management of osteosarcoma (OGS) lead to tumor progression and the development of metastasis, resulting in a decrease in overall survival (OS). The primary objective of this study was to determine whether delays occur in implementing the individual steps in the management of OGS in South India.MethodsIn this study, core biopsy reports between October 2019 and October 2021 were retrospectively examined for a diagnosis of OGS. The primary outcome variables in this study were time to MRI, time to biopsy, time to biopsy report, time to neoadjuvant chemotherapy (NACT), time to surgery, and time to adjuvant chemotherapy (ACT). Statistical analysis was performed by comparing the outcome variables with the hypothesized mean.ResultsThere were 38 patients with primary non-metastatic OGS. Of these, 92% received NACT, and 74% completed full treatment. The mean time to MRI was 11.3 ± 6.7 days, mean time to NACT was 15.3 ± 12.7 days, mean time to surgery was 31.1 ± 15.3 days, and mean time to ACT was 29.7 ± 10.1 days. Time to MRI was more than seven days in 68% of the cases, while time to NACT was more than seven days in 74%. Time to surgery was more than 21 days in 83% of the cases, and time to ACT was more than 21 days in 82% of the cases.ConclusionBased on our findings, there is a significant delay (p<0.05) in time to MRI, time to NACT, time to surgery, and time to ACT. The delay in time to surgery is more than the delay in time to MRI, time to NACT, and time to ACT. The delay is due to a variety of reasons, the most common being the long waiting period at the hospital.