Disparity in limb-salvage surgery among sarcoma patients

Stephanie Downing, Nita Ahuja, Tolulope A. Oyetunji, David Chang, Wayne A.I. Frederick

Research output: Contribution to journalArticle

Abstract

Background: Recent studies have shown that aggressive preoperative radiation increases the likelihood of limb salvage in sarcoma patients. Method: The Surveillance, Epidemiology and End Results database was used to run an adjusted logistic regression for the receipt of cancer-directed treatment modalities. Results: Of patients with specific surgical procedures recorded (n = 2,104), 86.0% had undergone a limb-sparing procedure. On bivariate analysis, African American patients were less likely to receive a limb-sparing procedure than white patients (80.4% vs 86.9%; P = .02). On multivariate analysis, African Americans were significantly more likely to receive preoperative radiation (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.22-4.40; P = .011), yet this did not translate into an increase in limb salvage (OR, .67; 95% CI, .42-1.08; P = .10). Limb salvage significantly increased for all groups in 2001 and after (OR, 2.75; 95% CI, 1.55-4.88; P = .001) without a decrease in survival. For those with tumors greater than 4 cm, there was a trend away from limb salvage for African Americans (OR, .59; 95% CI, .32-1.07; P = .08). Conclusions: Our results of an increase in limb-salvage surgeries after 2001 without a decrease in survival support previous studies. The trend away from limb salvage for African Americans cannot be answered by this study.

Original languageEnglish (US)
Pages (from-to)549-553
Number of pages5
JournalAmerican journal of surgery
Volume199
Issue number4
DOIs
StatePublished - Apr 1 2010

Keywords

  • Disparities in medicine
  • Limb-salvage surgery
  • SEER
  • Sarcoma

ASJC Scopus subject areas

  • Surgery

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