Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database
Table 1
Comparison of patient, tumor, and healthcare factors on time to treatment initiation.
Number of patients (%)
Median TTI, days (IQR)
value
Total number of patients
13329
22 (4–43)
Year of diagnosis
0.0002
2004
1189 (9)
22 (3, 43)
2005
1339 (10)
20 (0, 42)
2006
1258 (9)
20 (2, 41)
2007
1307 (10)
21 (2, 45)
2008
1290 (10)
21 (3.75, 42)
2009
1393 (11)
21 (2, 43)
2010
1370 (10)
22 (5, 46)
2011
1349 (10)
21 (4, 43)
2012
1451 (11)
22 (4, 43)
2013
1383 (10)
26 (7, 48)
Age (range)
0.0004
18–30 years
3220 (24)
19 (8, 35)
31–50 years
3882 (29)
22 (0, 44)
51–70 years
4248 (32)
23 (1, 47)
71+ years
1979 (15)
24 (3, 48)
Gender
0.0017
Male
7439 (56)
22 (6, 43)
Female
5890 (44)
21 (0, 43)
Race
0.0002
White
11277 (85)
21 (3, 42)
Black
1228 (9)
25 (6, 49.75)
Other/unknown
824 (6)
21 (3, 45)
Charlson/Deyo score
0.5091
0
11433 (86)
22 (4, 43)
1
1493 (11)
21 (1, 45)
≥2
403 (3)
24 (0, 54)
Income
0.4598
<$38,000
2216 (17)
22 (5, 46)
$38,000–$47,999
3130 (24)
22 (4, 44)
$48,000–$62,999
3504 (26)
21 (3, 42)
$63,000+
4236 (32)
22 (2.25, 42)
Unknown
243 (2)
21 (6, 40)
Histology
0.0001
Osteosarcoma
3979 (30)
24 (10, 42)
Chondrosarcoma
5608 (42)
19 (0, 43)
Ewing’s sarcoma
1313 (10)
19 (9, 32)
Chordoma
1354 (10)
30 (1, 63)
Other
1075 (8)
25 (7, 49)
Primary tumor site
0.0001
Upper extremity
1743 (13)
20 (0, 40)
Lower extremity
4482 (34)
20 (7, 37)
Pelvis
2543 (19)
30 (13, 56)
Other
4561 (34)
20 (0, 46)
Tumor size
0.0001
≤8.0 cm
6397 (48)
21 (0, 44)
>8.0 cm
6932 (52)
22 (7, 43)
Grade
0.0001
1, well differentiated
2488 (19)
11.5 (0, 40)
2, moderately differentiated
2246 (17)
26 (3, 49)
3 or 4, poorly/undifferentiated
4300 (33)
23 (10, 41)
Unknown
4295 (32)
22 (4, 45)
Clinical staging
0.0001
Stage I
4419 (33)
24 (0, 49)
Stage II
2518 (19)
25 (12, 42)
Stage III
216 (2)
23.5 (10.25, 45)
Stage IV
1288 (10)
21 (10, 38)
Unknown
4888 (37)
19 (0, 42)
Facility type
0.0001
Community cancer program
303 (2)
22 (0, 43)
Comprehensive cancer center
2026 (15)
19 (0, 41)
Academic center
5652 (42)
26 (5, 49)
Integrated network cancer program
544 (4)
20 (0, 44)
Other/unknown
4804 (36)
20 (6, 38)
Insurance
0.0001
Uninsured
674 (5)
24 (5.75, 48)
Private insurance
7488 (56)
20 (1, 41)
Medicaid
1372 (10)
23 (8, 46)
Medicare
2983 (22)
24 (3, 47)
Other/unknown
812 (6)
28 (9, 52)
Distance from facility
0.0001
<21 miles
6238 (47)
21 (1, 42)
21–50 miles
2846 (21)
22 (5, 42)
51–100 miles
1808 (14)
21 (5, 43)
>100 miles
2212 (17)
25 (6, 48.75)
Unknown
225 (2)
21 (6, 39.5)
Initial treatment modality
0.0001
Surgery
8949 (67)
19 (0, 44)
Radiation
765 (6)
37 (18, 68.5)
Systemic
3500 (26)
24 (14, 38)
Other
24 (0.2)
30.5 (2.5, 68.25)
Multimodal
91 (0.7)
23 (6, 49)
Transition in care
0.0001
Yes
5309 (40)
34 (17, 58)
Mean: 44.9 (43.7, 46.1)
No
8020 (60)
14 (0, 33)
Mean: 23.4 (22.7, 24.1)
Community Cancer Program volumes defined as 100–500 cancer cases annually. Integrated network cancer programs usually have a “unified cancer committee” and consist of “multiple facilities providing comprehensive services” [13]. Academic institutions are defined with the same quantitative volume definition as a comprehensive cancer center (>500 cancer cases annually) but also have a noted resident/medical education tract supported.
