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Racial and ethnic differences in treatment and survival among adults with primary extremity soft‐tissue sarcoma
Author(s) -
Martinez Steve R.,
Robbins Anthony S.,
Meyers Frederick J.,
Bold Richard J.,
Khatri Vijay P.,
Goodnight James E.
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23261
Subject(s) - medicine , hazard ratio , odds ratio , confidence interval , epidemiology , amputation , population , soft tissue sarcoma , surveillance, epidemiology, and end results , sarcoma , surgery , cancer registry , pathology , environmental health
BACKGROUND. Limb preservation is preferred to amputation for patients with extremity soft tissue sarcoma (ESTS). Disparities in the treatment and outcomes of several malignancies have been reported, but not for ESTS. The authors assessed racial/ethnic differences in patient‐ and tumor‐specific characteristics, treatment, and disease‐specific survival in a population of adults with ESTS. METHODS. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 6406 adult patients with ESTS who were diagnosed and treated between 1988 and 2003. Patients were categorized into 1 of 4 racial/ethnic groups: whites, blacks, Hispanics, and Asians. Comparisons of treatment and disease‐specific survival were conducted with regression models that adjusted for patient age, sex, SEER geographic region, extent of disease, tumor grade, tumor size, and histology. RESULTS. Relative to whites, blacks received lower rates of adjuvant radiation with surgery (odds ratio [OR], 0.77; 95% confidence interval [95% CI], 0.66–0.90). Hispanics received significantly lower rates of limb‐sparing surgery (OR, 0.76; 95% CI, 0.59–0.97). In a multivariate analysis controlling for patient age, sex, SEER geographic region, extent of disease, tumor grade, tumor size, and histology, blacks displayed a worse disease‐specific survival (hazard ratio [HR] 1.39; 95% CI, 1.13–1.70), whereas Asians demonstrated superior disease‐specific survival (HR, 0.67; 95% CI, 0.46–0.97). CONCLUSIONS. There were significant racial/ethnic differences in treatment and survival among adults with ESTS. Compared with whites, survival was poorer for blacks but better for Asians. These disparities were not explained by differences in patient or tumor characteristics. Cancer 2008. © 2008 American Cancer Society.