Prevalence of Soft Tissue and Bone Tumor Diagnostic Discrepancies from Initial to Referral Sarcoma Center
Issued Date
2025-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-86000784259
Journal Title
Siriraj Medical Journal
Volume
77
Issue
3
Start Page
183
End Page
193
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.77 No.3 (2025) , 183-193
Suggested Citation
Thongthammachat K., Muangsomboon S., Nimmannit A., Akewanlop C., Chandhanayingyong C., Phimolsarnti R., Chantharasamee J. Prevalence of Soft Tissue and Bone Tumor Diagnostic Discrepancies from Initial to Referral Sarcoma Center. Siriraj Medical Journal Vol.77 No.3 (2025) , 183-193. 193. doi:10.33192/smj.v77i3.270439 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/106755
Title
Prevalence of Soft Tissue and Bone Tumor Diagnostic Discrepancies from Initial to Referral Sarcoma Center
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Abstract
Objective: Diagnosing sarcoma can be challenging. This study evaluates pathological reviews of all sarcoma cases diagnosed at Siriraj Hospital, comparing initial diagnoses with those confirmed by a dedicated sarcoma pathologist Materials and Methods: Histopathological data from sarcoma patients at Siriraj Hospital were collected over five years. Initial diagnoses were compared to those determined by specialized sarcoma pathologists. Results: Among the 185 patients, 107 (57%) met the inclusion criteria and were then analyzed. Full concordance (perfect agreement between initial and sarcoma specialized pathologist) was observed in 28 (26.1%) cases, partial concordance (identical diagnosis with differences in classification and/or histopathological subtype differences) in 18 (16.8%) cases, and zero concordance (benign to malignant or vice versa, different histopathological type or invalidation of sarcoma diagnosis) in 61 (57%) cases. The rate of complete concordance was significantly higher in cases with initial complete immunohistochemical (IHC) studies (HR 4.17 and 95% CI 1.43–12.12; p = 0.009), tumors size 100 mm or more (HR 0.32 and 95% CI 0.10–0.99; p = 0.04) and younger than 18 years (HR 5.48, 95% CI 1.49–20; p = 0.01). The main discrepancies were histopathological type (n = 53, 49.5%), subtype (n = 8, 7.5%) and grade plus subtype (n = 4, 3.7%). The mean duration from diagnosis to treatment was 68 days (range: 0–272). Conclusion: The second opinion modified 73.8% of the initial diagnoses. However, no significant association was found between concordance of diagnosis and time to treatment initiation. Second opinion improves diagnostic accuracy and potentially enhance patient care.