Treatment delay of bone tumours, compilation of a sociodemographic risk profile: A retrospective study

Schnurr, Christoph; Pippan, Mathias; Stuetzer, Hartmut; Delank, K.-S.; Michael, Joern W.-P.; Eysel, Peer

doi:10.1186/1471-2407-8-22

Cited by 34 publications

(28 citation statements)

References 26 publications

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“…Compared to patients with low poverty, high‐poverty patients were more likely to reside in counties in which usually were lower health insurance coverage, diminished access to health care providers and fewer oncologist, all of which were related to a delay in diagnosis and higher risk of early death. Indeed, a delay in diagnosis substantially increases the risk of an advanced stage of disease at presentation, which is significantly associated with decreased survival 29, 30, 31, 32. However, with the increasing improvement of health care policies and medical insurance, the patients with low income could also have access to medical consultation and better treatment resources, thereby they could have a progress survival over time 33, 34…”

Section: Discussionmentioning

confidence: 99%

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Sun

et al. 2018

Cancer Medicine

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PurposeOsteosarcoma is the most common primary malignancy of bone, and typically occurs among children and adolescence. This study aims to evaluate treatment outcomes among children, adolescents and young adults with osteosarcoma over the three decades by the changes in the long‐term relative survival.MethodsOsteosarcoma incidence and relative survival data from Surveillance, Epidemiology, and End Results (SEER) registries during 1984‐2013 were analyzed. The survival differences over three decades, age, sex, race, and socioeconomic status (SES) were assessed by comparing Kaplan‐Meier curves.ResultsThe overall incidence of osteosarcoma kept relatively stable with 0.4 per 100 000 in the three decades with the peak incidence occurring in the aged 10‐19 group. The 10‐year relative survival rate (RSR) increased from 57.7% to 61.0% in the three decades, with the greatest increase in the aged 0‐9 group from 48.2% to 65.7%. The 10‐year RSR improved from 54.1% to 61.5% in males, and from 62.4% to 63.0% in females, respectively, in the three decades. Furthermore, survival dramatically improved from 30% to 60% in the high‐poverty group over the three decades.ConclusionThis study demonstrated that the overall incidence of osteosarcoma remained stable, with an improvement in survival in the three decades. The improved survival was greater in males than in females in the three decades. Furthermore, the survival significantly increased in high‐poverty group, which was attributed to increasing improved health care system and patients with low finance can also have access to receiving effective and consistent treatment without distinction.

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Section: Discussionmentioning

confidence: 99%

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Sun

et al. 2018

Cancer Medicine

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“…These long symptom durations are due to both patients and health professionals. Several factors may influence diagnosis delays, for example, delays may be greater for those living in rural compared with urban areas (Schnurr et al, 2008), while the site and biology of the tumour may also determine the extent of delay. Ewing sarcoma patients are more likely to have a longer symptom interval than osteosarcoma due to its greater propensity for growth in the axial skeleton.…”

Section: Discussionmentioning

confidence: 99%

Incidence and survival of childhood bone cancer in northern England and the West Midlands, 1981–2002

et al. 2009

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There is a paucity of population-based studies examining incidence and survival trends in childhood bone tumours. We used high quality data from four population-based registries in England. Incidence patterns and trends were described using Poisson regression. Survival trends were analysed using Cox regression. There were 374 cases of childhood (ages 0 -14 years) bone tumours (206 osteosarcomas, 144 Ewing sarcomas, 16 chondrosarcomas, 8 other bone tumours) registered in the period 1981 -2002. Overall incidence (per million person years) rates were 2.63 (95% confidence interval (CI) 2.27 -2.99) for osteosarcoma, 1.90 (1.58 -2.21) for Ewing sarcoma and 0.21 (0.11 -0.31) for chondrosarcoma. Incidence of Ewing sarcoma declined at an average rate of 3.1% (95% CI 0.6 -5.6) per annum (P ¼ 0.04), which may be due to tumour reclassification, but there was no change in osteosarcoma incidence. Survival showed marked improvement over the 20 years (1981 -2000) for Ewing sarcoma (hazard ratio (HR) per annum ¼ 0.95 95% CI 0.91 -0.99; P ¼ 0.02). However, no improvement was seen for osteosarcoma patients (HR per annum ¼ 1.02 95% CI 0.98 -1.05; P ¼ 0.35) over this time period. Reasons for failure to improve survival including potential delays in diagnosis, accrual to trials, adherence to therapy and lack of improvement in treatment strategies all need to be considered.

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“…Nonetheless, delay in presentation, referral, diagnosis, and/or treatment may result in limb loss or even death, 1 especially in patients with aggressive osteosarcomas that predominantly affect the young. We reviewed a series of patients with osteosarcomas around the knee joint to identify common initial symptoms and elucidate reasons for delayed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Initial Symptoms and Delayed Diagnosis of Osteosarcoma around the Knee Joint

Pan

Chan

Chia

2010

J Orthop Surg (Hong Kong)

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Purpose. To identify initial symptoms of osteosarcoma around the knee joint. Methods. Records of 19 men and 11 women aged 9 to 34 (mean, 17) years with osteosarcoma around the knee joint were reviewed. Each patient was interviewed (for a mean of 1.5 hours), and a detailed history of symptom onset recorded. Results. In all patients, the first symptom was pain, which was more pronounced on weight bearing in 16 (53%) of them and was worse at night in 11 (37%). Swelling was noticed in 28 patients (a mean of 7 weeks after pain onset). 16 (53%) of the patients had a history of minor trauma around the time of symptom onset. 20 (67%) of the patients had a limp, in 9 of whom it was not associated with pain on weight bearing; only 2 (7%) had a pathological fracture. The mean interval from the onset of symptoms (pain) to presentation was 10 (range, 0-49) weeks. The mean interval from Journal of Orthopaedic Surgery �� presentation to radiography was 3 (range, 0-20) weeks; in 8 patients this interval exceeded 3 weeks despite a noticeable swelling. The mean interval from radiography to referral to our hospital was 2 (range, 0-14) weeks. Together with the 2 weeks for diagnostic workup and biopsy, the mean total delay was 17 (range, 4-55) weeks. Conclusion. Physicians should be aware of the symptoms of osteosarcoma and promptly refer patients to tumour centres, especially adolescents, those who present with pain that may be worse at night and on weight bearing, and those in whom a swelling and/or a limp is evident.

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Treatment delay of bone tumours, compilation of a sociodemographic risk profile: A retrospective study

Cited by 34 publications

References 26 publications

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

Incidence and survival of childhood bone cancer in northern England and the West Midlands, 1981–2002

Initial Symptoms and Delayed Diagnosis of Osteosarcoma around the Knee Joint

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