Malignant neoplasms originating from the bones of the foot: Predilection of hematological malignancies and sex‐related and ethnic disparities in amputation

Abstract

Purpose: Neoplasms originating from the "small bones of the lower limb and the overlapping joints" are rare but portend a serious prognosis. Current study utilizes a population-based registry in the United States to characterize the malignancies of the foot. Methods: National Cancer Institute's Surveillance, Epidemiology and End Result database from 1975 to 2017 was queried to report incidence and survival data in 514 patients in the Uited States. Kaplan-Meier and Cox Regression were used to determine the prognostic factors affecting survival. Chi square test was used to assess the correlation.Results: Hematological malignancies constituted 14.8% of the entire cohort. Incidence of the foot neoplasms was 0.024 per 100 000 persons in 2017 and has not significantly changed since 1975 (p > 0.05). Disease-specific-5-year survival for the entire cohort was 73%. On multivariate analysis younger age groups, "localized" stage and extent of surgical resection were predictors of improved outcomes. A significant correlation was found between amputation with male sex and Hispanic ethnicity. Conclusions:The current study analyzes data from population-based registry reporting incidence and survival data for patients with neoplasms of the foot. Independent prognostic factors include age, stage and extent of surgical resection.

Socioeconomic disparities in musculoskeletal oncology

“…Furthermore, “Hispanic” ethnicity was found to have a 40% increased likelihood of undergoing amputation in the same study 41 . Similar results were reported in a study focusing on bone malignancies originating in the foot specifically 11 . Racial disparities in disease‐specific survival were also reported for patients with hand sarcoma 42 .…”

“…41 Similar results were reported in a study focusing on bone malignancies originating in the foot specifically. 11 Racial disparities in disease-specific survival were also reported for patients with hand sarcoma. 42 Additionally, there are several studies which suggest that there are racial and insurance-related disparities in morbidity, mortality, length of stay and discharge destinations among patients undergoing oncological spinal surgeries.…”

“…8 Monitoring and reduction of health care disparities has been a long-term goal of current the US health policy. 9 There have been reports implicating racial/ethnic, 10,11 socioeconomic 12 and insurance-related 13 disparities in survival among patients primary bone malignancies and soft tissue sarcomas utilizing the National Cancer Institute's (NCI) Surveillance, Epidemiology and End Result (SEER). 14 Such reports 15,16 have also emanated from American College of Surgeon's (ACS) National Cancer Database (NCDB).…”