Poverty, race, ethnicity, and survival in pediatric nonmetastatic osteosarcoma: a Children's Oncology Group report.

Autor:	Ilcisin L; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA.; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Han R; Children's Oncology Group, Monrovia, CA, USA., Krailo M; Children's Oncology Group, Arcadia, CA, USA.; Department of Population and Public Health Sciences Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Shulman DS; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA., Weil BR; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Weldon CB; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA., Umaretiya P; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA., Aziz-Bose R; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA., Greenzang KA; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA., Gorlick R; Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Reed DR; Division of Pediatric Solid Tumors, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Randall RL; Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA., Nadel H; Division of Radiology, Lucille Packard Children's Hospital at Stanford University, Stanford, CA, USA., Binitie O; Department of Surgery, Moffitt Cancer Center, Tampa, FL, USA., Dubois SG; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA., Janeway KA; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA., Bona K; Department of Pediatric Oncology, Division of Population Sciences, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Oct 01; Vol. 116 (10), pp. 1664-1674.
DOI:	10.1093/jnci/djae103
Abstrakt:	Background: Children living in poverty and those of marginalized race or ethnicity experience inferior disease outcomes across many cancers. Whether survival disparities exist in osteosarcoma is poorly defined. We investigated the association between race, ethnicity, and proxied poverty exposures and event-free and overall survival for children with nonmetastatic osteosarcoma receiving care on a cooperative group trial. Methods: We conducted a retrospective cohort study of US patients with nonmetastatic, osteosarcoma aged 5-21 years enrolled on the Children's Oncology Group trial AOST0331. Race and ethnicity were categorized to reflect historically marginalized populations, as Hispanic, non-Hispanic Black, non-Hispanic Other, and non-Hispanic White. Poverty was proxied at the household and neighborhood levels. Overall survival and event-free survival functions of time from trial enrollment were estimated using the Kaplan-Meier method. Hypotheses of associations between risks for event-free survival, death, and postrelapse death with race and ethnicity were assessed using log-rank tests. Results: Among 758 patients, 25.6% were household-poverty and 28.5% neighborhood-poverty exposed. Of the patients, 21% of children identified as Hispanic, 15.4% non-Hispanic Black, 5.3% non-Hispanic Other, and 54.0% non-Hispanic White. Neither household or neighborhood poverty nor race and ethnicity were statistically significantly associated with risks for event-free survival or death. Postrelapse risk for death differed statistically significantly across race and ethnicity with non-Hispanic Black patients at greatest risk (4-year postrelapse survival 35.7% Hispanic vs 13.0% non-Hispanic Black vs 43.8% non-Hispanic Other vs 38.9% non-Hispanic White; P = .0046). Conclusions: Neither proxied poverty exposures or race and ethnicity were associated with event-free survival or overall survival, suggesting equitable outcomes following frontline osteosarcoma trial-delivered therapy. Non-Hispanic Black children experienced statistically significant inferior postrelapse survival. Investigation of mechanisms underlying postrelapse disparities are paramount. (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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