Center for Cancer and Blood Disorders, Department of Pediatrics.
Center of Biostatistics, University of Colorado School of Medicine, Aurora, CO.
J Pediatr Hematol Oncol. 2023 Jan 1;45(1):e31-e43. doi: 10.1097/MPH.0000000000002531. Epub 2022 Aug 26.
Osteosarcoma (OST) and Ewing sarcoma (ES) are the most common pediatric bone cancers. Patients with metastatic disease at diagnosis have poorer outcomes compared with localized disease. Using the Surveillance, Epidemiology, and End Results registries, we identified children and adolescents diagnosed with OST or ES between 2004 and 2015. We examined whether demographic and socioeconomic disparities were associated with a higher likelihood of metastatic disease at diagnosis and poor survival outcomes. In OST, Hispanic patients and those living in areas of high language isolation were more likely to have metastatic disease at diagnosis. Regardless of metastatic status, OST patients with public insurance had increased odds of death compared to those with private insurance. Living in counties with lower education levels increased odds of death for adolescents with metastatic disease. In ES, non-White adolescents had higher odds of death compared with white patients. Adolescents with metastatic ES living in higher poverty areas had increased odds of death compared with those living in less impoverished areas. Disparities in both diagnostic and survival outcomes based on race, ethnicity, and socioeconomic factors exist in pediatric bone cancers, potentially due to barriers to care and treatment inequities.
骨肉瘤（OST）和尤文肉瘤（ES）是最常见的儿童骨癌。与局限性疾病相比，诊断时患有转移性疾病的患者预后较差。我们使用监测、流行病学和最终结果登记处，确定了 2004 年至 2015 年间诊断为 OST 或 ES 的儿童和青少年。我们研究了人口统计学和社会经济差异是否与更高的诊断时转移性疾病的可能性和较差的生存结果相关。在 OST 中，西班牙裔患者和居住在语言隔离程度较高地区的患者更有可能在诊断时出现转移性疾病。无论转移性疾病的状态如何，与私人保险相比，拥有公共保险的 OST 患者死亡的几率更高。对于患有转移性疾病的青少年来说，居住在教育水平较低的县的人死亡的几率更高。在 ES 中，与白人患者相比，非白人青少年死亡的几率更高。与居住在贫困程度较低地区的患者相比，居住在贫困程度较高地区的转移性 ES 青少年死亡的几率更高。在儿科骨癌中，基于种族、族裔和社会经济因素的诊断和生存结果存在差异，这可能是由于治疗和护理方面的障碍造成的。
