Comprehensive Analysis of Osteosarcoma Referral Letters: Insights into Medical Collaboration and Diagnostic Practices at Our Hospital.

Background/aim: This study aimed to assess the status of medical collaboration between our hospital and affiliated institutions based on referral letters for patients with osteosarcoma.

Patients and methods: A single-center retrospective analysis of osteosarcoma referrals was conducted between September 1, 2012, and March 31, 2023. Fourteen patients were included (eight males, six females; mean age=28 years, range=8-74 years) each with a pathologically confirmed diagnosis of a malignant soft-tissue tumor and available referral documentation from previous physicians. Survey parameters included type of referral hospital, geographical area, and medical department of the referral hospital, as well as imaging and blood tests conducted and the corresponding findings.

Results: Patients were referred from various medical institutions: Six from general hospitals, six from clinics, one from a university hospital, and one from a clinic with beds. Most patients (n=10) were from southern Osaka. Among the referrals, 11 patients were referred to orthopedics, two to surgery, and one to pediatrics. Analysis of imaging studies showed eight patients with only radiographs; three patients with radiographs, computed tomography (CT), and magnetic resonance imaging (MRI); one patient with only CT; one patient with only MRI; and one patient with both radiographs and CT. Imaging findings included indications of suspected malignancy in 12 patients and suspected bone tumors in two. Blood tests were conducted in two patients, namely alkaline phosphatase and C-reactive protein, and alkaline phosphatase and lactate dehydrogenase, respectively. Blood tests were not performed in the remaining 12 patients.

Conclusion: Referrals for patients with osteosarcoma at our facility and related facilities were well documented, ensuring informative content and adequate medical coordination.