Time to Treatment Initiation and Survival in Adult Localized High-Grade Bone Sarcoma

Area of Science:

• Oncology
• Surgical Oncology
• Biostatistics

Background:

• The prognostic significance of the time from diagnosis to treatment initiation (TTI) in bone sarcoma remains under-evaluated.
• Understanding factors influencing survival is critical for optimizing patient outcomes in bone sarcoma management.

Purpose of the Study:

• To investigate the association between TTI and overall survival in adult patients diagnosed with primary bone sarcoma.
• To identify other patient, disease, and healthcare-related factors impacting survival in this population.

Main Methods:

• Retrospective analysis of 2,122 adult patients with localized, high-grade primary bone sarcoma from the National Cancer Database (2004-2012).
• Time to treatment initiation (TTI) defined as days from diagnosis to treatment start.
• Kruskal-Wallis and Cox regression analyses were used to assess survival associations.

Main Results:

• No significant association was found between a 10-day increase in TTI and decreased overall survival (HR=1.00, P=0.72).
• Survival outcomes did not differ across various TTI intervals (14, 30, 60, 90, 150 days).
• Factors significantly associated with decreased survival included older age, higher comorbidity scores, pelvic tumor site, larger tumor size, and radiation therapy. Increased survival was associated with specific tumor types (chordoma, chondrosarcoma), academic treatment centers, and certain insurance providers.

Conclusions:

• Extended time to treatment initiation (TTI) does not appear to negatively affect overall survival in adults with localized, high-grade primary bone sarcoma.
• These findings can inform patient counseling, reassuring them about potential delays for second opinions or referrals to specialized sarcoma centers.