Optimal timeframes & summary
Timeframes should be informed by evidence-based guidelines (where they exist) while recognising that shorter timelines for appropriate consultations and treatment can reduce patient distress. The following recommended timeframes are based on consensus expert advice from the Sarcoma Working Group.
Timeframes for care
| Step in pathway | Care point | Timeframe |
| Presentation, initial investigations and referral | 2.3 Referral to specialist | A suspected sarcoma should be referred to a specialist within two weeks; first specialist assessment within four weeks of referral. |
| Diagnosis, staging and treatment planning | 3.1 Diagnostic work-up | Completion of all investigations within two
weeks of first specialist assessment. |
| 3.2.4 Multidisciplinary team
meeting |
All newly diagnosed patients should be discussed in a multidisciplinary team meeting before beginning treatment. | |
| Treatment | 4.2 Treatment options | Patients begin their treatment within three
weeks of the decision to treat. |
The optimal cancer care pathway outlines seven critical steps in the patient journey. While the seven steps appear in a linear model, in practice, patient care does not always occur in this way but depends on the particular situation (such as the type of cancer, when and how the cancer is diagnosed, prognosis, management, patient decisions and the patient’s physiological response to treatment).
Sarcomas are a heterogeneous group of malignancies and include many anatomical sites and subtypes. Sarcomas account for less than 1 per cent of all adult solid malignant cancers, and given the number of histologic types, any given type of sarcoma is extremely rare (Herzog 2005). The pathway includes all bone and soft tissue sarcomas. Gastrointestinal stromal tumours (GIST), Kaposi’s sarcoma and desmoid fibromatosis are excluded. This document refers to ‘sarcoma’ when the recommendations are intended to apply to both bone and soft tissue sarcomas.
Special considerations
The pathway describes the optimal cancer care that should be provided at each step. Sarcomas disproportionately affect AYA patients, with more than half of all cases being diagnosed between the ages of 15 and 39 (Davis et al. 2017). The significant developmental change that occurs during this life stage complicates a sarcoma diagnosis, often leading to unique physical, social and emotional impacts at the time of diagnosis and throughout the treatment pathway (Smith et al. 2012). Ensuring access to expert AYA health professionals who understand the specific needs of this population, and ensuring they are linked with a youth cancer service, are essential considerations in providing care to this group. Further considerations for this group are outlined under [ocp-link to=special-groups]Populations with special needs.
