| Affiliation: | 1. Department of Pediatric Surgery, McGovern Medical School, Houston, TX;2. Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX;3. Division of Pediatrics, Children''s Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX;4. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX |
| Abstract: | ![]()
PurposeThe purpose of this study was to determine whether racial/ethnic disparities exist in disease presentation, treatment, and survival among children and adolescents with extremity sarcoma.MethodsThe Surveillance, Epidemiology, and End Results (SEER) data were analyzed for patients < 20 years old with soft-tissue extremity sarcomas from 1973 to 2013. Multivariate logistic regression was performed to determine the association between race/ethnicity and disease stage at presentation and likelihood of surgical resection. Overall survival (OS) was evaluated using hazard ratios with 95% confidence intervals.Results1261 cases were identified: 650 (52%) non-Hispanic whites (NHW), 313 (25%) Hispanics, 182 (14%) non-Hispanic blacks (NHB), and 116 (9%) other race/ethnicity. Logistic regression results showed that Hispanics and NHB were 51% and 44%, respectively, less likely to undergo surgical resection compared to NHW (OR = 0.49, 95% CI: 0.30–0.80; OR = 0.56, 95% CI: 0.32–0.98, respectively). Factors associated with failure to undergo surgical resection included histology, lower extremity site, tumor size, and distant metastases. OS based on race/ethnicity significantly differed using the log-rank test, with NHB having the worst survival (p < 0.05).ConclusionsWe conclude that NHB, Hispanics, and other race/ethnicity were less likely to undergo surgical resection for extremity sarcoma. Further work is needed to better characterize and eliminate disparities in the management and outcomes of children with extremity sarcomas.Type of studyPrognosis study.Level of evidenceIV |
