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Black patients with soft tissue sarcoma of extremities more likely to have poorer outcomes
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NEW ORLEANS — Black patients with soft tissue sarcoma of the extremities are more likely to have amputation, larger tumors, poorer resources and poorer survival than white patients and patients of other races, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“This is a large database review and it reveals concerning trends still in the treatment of black patients with soft tissue sarcoma of the extremities,” Alexander L. Lazarides, MD, said, here.
In the retrospective study, Lazarides and colleagues used the National Cancer Database to identify 14,067 patients with soft tissue sarcoma of the extremities from 1998 to 2012. Overall, 84.9% of patients were white, 11% of patients were black and 4.1% were in an independent category, which was predominantly Indian and Asian patients. Researchers determined the independent impact of race, ethnicity and socioeconomic status on outcomes in patients with soft tissue sarcoma of the extremities and evaluated long-term survival.
They found black patients were 7.18% more likely than white patients (5.65%) or patients in the independent category (4.47%) to have an amputation. Black patients were more likely to be uninsured and had higher Charlson Comorbidity Scores than the other races, he said, which is known to contribute to poorer overall outcomes. He also said black patients were less likely to have above-median education or income levels.
Lazarides said black patients presented with tumors larger in size and were less likely to have a higher-grade tumor. Black patients were also found to have poorer overall survival and higher likelihood of death. He said black race was an independent predictor of 5-year survival, with the 5-year survival of 61% for black patients, 67% for white patients and 70% for patients in the other category. ‒ by Kristine Houck, MA, ELS
Reference:
Lazarides AL, et al. Paper #436. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.
Disclosures: Lazarides reports no relevant financial disclosures.
Perspective
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Monika M. Safford, MD
Racial disparities in health outcomes remain a stubborn challenge in the United States. Duke University researchers recently reported on disparities in outcomes of soft tissue sarcoma, adding to the list of conditions for which disparities have been reported. The team studied over 14,000 patients with soft tissue sarcomas of the extremities and found that black patients had larger tumors at presentation, were 27% more likely to receive amputation, and had lower survival at 5 years after diagnosis compared to whites. This study highlights the importance of continued efforts to better engage blacks in health care to achieve more equitable health outcomes.
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