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Diagnostic delay in rhabdomyosarcoma: have we improved our diagnostic capabilities?
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  • Maria Carmen Affinita,
  • Stefano Chiaravalli,
  • Giuseppe Maria Milano,
  • Ida Russo,
  • Katia Perruccio,
  • A. Tagarelli,
  • Patrizia Bertolini,
  • carla manzitti,
  • F. Mercolini,
  • Angela Tamburini,
  • Francesco De Leonardis,
  • Paolo D'Angelo,
  • S. Cardellicchio,
  • Andrea Di Cataldo,
  • Daniela Di Pinto,
  • Rosamaria Mura,
  • Andrea Ferrari,
  • Gianni Bisogno
Maria Carmen Affinita
Azienda Ospedale Universita Padova

Corresponding Author:mariacarmen.affinita@aopd.veneto.it

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Stefano Chiaravalli
Fondazione IRCCS Istituto Nazionale dei Tumori
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Giuseppe Maria Milano
Ospedale Pediatrico Bambino Gesu IRCCS
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Ida Russo
Ospedale Pediatrico Bambino Gesu IRCCS
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Katia Perruccio
Azienda Ospedaliera di Perugia
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A. Tagarelli
Azienda Ospedale Universita Padova
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Patrizia Bertolini
Azienda Ospedaliero-Universitaria di Parma
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carla manzitti
CISEF Gaslini
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F. Mercolini
IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola
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Angela Tamburini
Azienda Ospedaliero Universitaria Meyer Pediatria medica
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Francesco De Leonardis
Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari
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Paolo D'Angelo
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina Benfratelli
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S. Cardellicchio
Azienda Ospedaliero Universitaria Meyer Pediatria medica
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Andrea Di Cataldo
Universita degli Studi di Catania Dipartimento di Medicina Clinica e Sperimentale
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Daniela Di Pinto
Azienda Ospedaliera Universitaria Luigi Vanvitelli
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Rosamaria Mura
Ospedale Microcitemico
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Andrea Ferrari
Fondazione IRCCS Istituto Nazionale dei Tumori
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Gianni Bisogno
Azienda Ospedale Universita Padova
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Abstract

not-yet-known not-yet-known not-yet-known unknown Background: Timely diagnosis is critical in pediatric oncology to optimize treatment outcomes. Diagnostic delays may impact tumor extension and prognosis, necessitating analysis of diagnostic intervals across different neoplasms. Methods: We analyzed data from 749 pediatric patients diagnosed with rhabdomyosarcoma between 1996 and 2016. Diagnostic interval (DI) was defined as days from symptom onset to diagnosis, and treatment interval (TI) from symptom onset to treatment initiation. Factors influencing DI and TI were collected, including patient age, histology, tumor characteristics, and protocol of treatment. Survival outcomes were assessed using Kaplan-Meier analysis. Results: Median DI was 32 days, decreasing insignificantly from 1996-2004 to 2005-2016. Longer DI was associated with metastatic disease (p=0.0021). The proportion of patients diagnosed within one month increased over time, but remained lower for metastatic cases. Median TI was 48 days, unchanged over time. Longer TI correlated with larger tumors (p<0.0001). Adolescents had prolonged DI (>2 months) more frequently. The quantile regression models showed that on univariate analysis DI was associated with age at diagnosis, unfavourable histology and metastatic diaeses, but not confirmed in multivariate Five-year event-free survival (EFS) and overall survival (OS) were 59.7% and 69.3%, respectively. Conclusions: This study evaluated the role of timely diagnosis and treatment initiation in pediatric patients with rhabdomyosarcoma . Our data highlights that DI and TI are crucial in adolescents and often longer in metastatic patients. Future efforts should focus on streamlining access to diagnostic facilities and improving processes to ensure timely interventions, especially for patients presenting with more advanced disease.