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10055 Background: STS are 1% of malignant tumors in adults. Rarity, heterogeneity in presentation, low expertise in primary care physicians (PCP) or in general hospitals, organisation problems in specialized centers may cause a delay in both diagnosis and treatment. Aim of this study is to acknowledge the barriers to optimal care and the consequences of the delay on prognosis. Methods: Patients with STS of the extremities, trunk, retroperitoneum treated and followed from 1999 to 2011 by the same multidisciplinary group were included. Time and pattern of symptoms onset, anatomic site, tumor volume, patients’ age, gender and home, interval between diagnosis and surgical treatment or neoadjuvant chemotherapy; time to start adjuvant RT or CT were considered in a univariate - multivariate analysis. Results: 449 adult patient (53% F, 47% M, median age 55 years) were followed for a median time of 116.38 months. 65.7% of STS were at the extremities, 17.6% retroperitoneal, 16.7% at the trunk wall. Median volume at diagnosis was 8 cm for trunk and extremities; 15 cm for retroperitoneum. Commonest histologies: liposarcoma. 18.2%; leiomyo 16.8%; mixofibro 13.6%. Increasing mass, pain, and abdominal disconfort were the main revealing signs of diseases. Median time of delay were: from onset of symptom to first medical visit 68 days for trunk and extremities, 82 for retroperitoneum; 104 days from symptoms to histological diagnosis; 129 days from symptoms to start of therapy. Time to surgery after definitive diagnosis was 12 days in extremities and 21 in abdomen. Adjuvant CT started 22 days after surgery for extremities, 25 in trunk, 35 in retroperitoneum. RT initiated after 78 days. Longer delay in treatment lead to worse prognosis: MS 89.95 months if delay was > 3 months; 190.40 months if wait was < 3 months (p 0.007). Conclusions: Low self consciousness of the patient; misdiagnosis or inadequate approach in general hospitals; late referral to specialized centres are 75% of the cause of wasted time. Organization problems at the referral Centre concur for 25% of delay. Guidelines implementation and educational programme among general population and PCP are necessary.

10086 Background: Neoadjuvant chemotherapy (NACT) has a well established role in multidisciplinary treatment of soft tissue sarcomas (STS). Unfortunately no sure predictive factors have been identified in order to screen those patients who are going to benefit from NACT. Topoisomerase IIα (topo IIα) is a positive target for anthracyclines. Bcl-2 is a molecular target for alchilants. P-glycoprotein gp170 is a member of multidrug resistance (MDR) complex. This study aimed to evaluate if topo IIα, gp170, bcl-2, tumor burden and histology could predict the response to NACT in locally advanced STS of the extremities. Methods: Twenty-nine patients with STS of the extremities (median age 61 yrs, range 35-82) received a median of 3 cycles of Epirubicine and Ifosfamide as NACT. Topo IIα, gp170, bcl-2 were assessed by IHC either on pre-treatment biopsies and on post-treatment surgical specimens. Bioptical specimens were categorized in low and high expression according to a cut-off corresponding to the median value ...