Background/Objectives: To review the problem of diagnostic delay in soft tissue sarcomas with the aim of identifying its causes and consequences, understanding how to clinically suspect and refer them, and evaluating the main limitations of the referral guidelines already in use. Methods: A systematic review of the available literature was performed, focusing on the theoretical framework, the elements and time intervals to be considered, causes and consequences, “red flag” symptoms/signs, the main referral guidelines in use, their results, and the methods used to avoid excessive referrals. Results: Diagnostic delay in soft tissue sarcomas is a frequent event that is poorly characterized and has important consequences, including prognostic, medico-legal and psycho-social effects. The common denominator is the lack of knowledge and awareness. Several referral guidelines have been described, and most of them are based on clinical data. Their results have been disappointing. Thus, it is necessary to implement new methods to improve their results and avoid the overload of pre-referral imaging systems, sarcoma diagnostic triage meetings, and telemedicine systems. Conclusions: Sarcoma units and health system leaders need to study this issue to determine the extent of the problem and its causes. Without this information, it is almost impossible to properly address the problem and take corrective actions. Early referral of suspected soft tissue sarcoma lesions, although desirable, is a complex issue due to the non-specificity of the symptoms. Existing clinical referral guidelines need to be modified to improve detection and conversion rates.
背景/目的：回顾软组织肉瘤诊断延迟问题，旨在明确其成因与后果，理解临床疑诊与转诊要点，并评估现行转诊指南的主要局限性。方法：对现有文献进行系统性综述，重点关注理论框架、需考量的要素与时间间隔、成因与后果、"警示性"症状/体征、主要现行转诊指南及其应用效果，以及避免过度转诊的方法。结果：软组织肉瘤诊断延迟现象普遍存在，其特征尚未明确界定，且会产生包括预后、医疗法律及社会心理影响在内的重要后果。其共同症结在于认知与意识的缺乏。目前已提出多种转诊指南，其中多数基于临床数据，但实施效果均不尽如人意。因此亟需采用新方法以提升转诊效能，同时避免转诊前影像系统、肉瘤诊断分诊会议及远程医疗系统的超负荷运转。结论：肉瘤诊疗中心与卫生系统管理者需深入研究该问题，以明确其严重程度及根本成因。缺乏这些关键信息，将难以有效解决问题并采取纠正措施。虽然早期转诊可疑软组织肉瘤病变是理想目标，但由于症状的非特异性，这仍是一个复杂难题。现有临床转诊指南需进行修订，以提高检出率与转诊转化率。
肿瘤(癌症)患者之家