(P 093) TIME TO TREATMENT INITIATION IN PRIMARY EXTREMITY SARCOMA: AN ANALYSIS OF DATABASE FROM A REGIONAL CANCER CENTRE OF LOW/MIDDLE INCOME COUNTRY

Objective: Time to treatment initiation (TTI) is being used as a quality control metric to improve patient outcomes. Prolonged TTI negatively impacts survival in primary extremity sarcoma (PES). The aim of the study was to quantify the time to treatment initiation in primary extremity sarcoma & identify factors affecting TTI in our setting.

Methods: This was a retrospective study carried out at our center over 537 patient of primary extremity sarcoma received initial treatment during the time period of 1st January 2014 to 30th December 2018. Various parameters like tumor, treatment, socioeconomic and healthcare system characteristics were collected & analyzed using T-test, Kruskal–Wallis & Cox regression model.

Results: In our study median & mean, TTI in primary bone sarcoma (PBS) was 34 & 41.81 days while among primary soft tissue sarcoma (PSTS) was 30 & 37.06 days respectively. Increased TTI associated with grade ≥II tumour (IRR-1.28, P=0.001), gluteal (IRR-1.48, P-value-0.001) & upper extremity (IRR-1.33, P=0.015) as location. The diagnosis of leiomyosarcoma (IRR-0.87, P=0.045), female gender (IRR-0.87, P=0.045), thigh as a primary site (IRR-0.74, P=0.001) & Surgery as initial treatment modality (IRR-0.814, 95% CI-0.75-0.88, P=0.001) significantly decreased the TTI.

Conclusion: Potential causes of prolongation of TTI are multifactorial in nature. Primary site, grade & non-surgical modality as index treatment significantly prolonged the TTI in PES. As TTI is more commonly used as a quality metric, identification of those factors leads to streamline treatment, improve patient care, and may improve overall survival.

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