Racial and ethnic differences in treatment and survival among adults with primary extremity soft-tissue sarcoma

Steve R. Martinez, Anthony S. Robbins, Frederick J Meyers, Richard J Bold, Vijay P. Khatri, James E Goodnight Jr

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1162-1168
Number of pages7
JournalCancer
Volume112
Issue number5
DOIs
StatePublished - Mar 1 2008

Fingerprint

Sarcoma
Extremities
Survival
Neoplasms
Confidence Intervals
Epidemiology
Hispanic Americans
Therapeutics
Histology
Odds Ratio
Amputation
Ethnic Groups
Lower Extremity
Multivariate Analysis
Databases
Radiation
Population

Keywords

  • Amputation
  • Disparities
  • Ethnicity
  • Extremity
  • Limb-sparing
  • Race
  • Radiation
  • Sarcoma
  • Soft tissue

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Racial and ethnic differences in treatment and survival among adults with primary extremity soft-tissue sarcoma. / Martinez, Steve R.; Robbins, Anthony S.; Meyers, Frederick J; Bold, Richard J; Khatri, Vijay P.; Goodnight Jr, James E.

In: Cancer, Vol. 112, No. 5, 01.03.2008, p. 1162-1168.

Research output: Contribution to journalArticle

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title = "Racial and ethnic differences in treatment and survival among adults with primary extremity soft-tissue sarcoma",
abstract = "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.",
keywords = "Amputation, Disparities, Ethnicity, Extremity, Limb-sparing, Race, Radiation, Sarcoma, Soft tissue",
author = "Martinez, {Steve R.} and Robbins, {Anthony S.} and Meyers, {Frederick J} and Bold, {Richard J} and Khatri, {Vijay P.} and {Goodnight Jr}, {James E}",
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T1 - Racial and ethnic differences in treatment and survival among adults with primary extremity soft-tissue sarcoma

AU - Martinez, Steve R.

AU - Robbins, Anthony S.

AU - Meyers, Frederick J

AU - Bold, Richard J

AU - Khatri, Vijay P.

AU - Goodnight Jr, James E

PY - 2008/3/1

Y1 - 2008/3/1

N2 - 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.

AB - 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.

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KW - Disparities

KW - Ethnicity

KW - Extremity

KW - Limb-sparing

KW - Race

KW - Radiation

KW - Sarcoma

KW - Soft tissue

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