High Community-Level Social Vulnerability is Associated with Worse Recurrence-Free Survival (RFS) After Resection of Extremity and Truncal Soft Tissue Sarcoma

Raymond S Traweek ¹, Heather G Lyu ¹, Russell G Witt ^1,2

⁰Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Annals of Surgical Oncology +

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February 23, 2024

View abstract on PubMed

Summary

High social vulnerability is linked to poorer recurrence-free survival in soft tissue sarcoma patients. Addressing social risk factors is crucial for improving outcomes in sarcoma treatment.

Area Of Science

Oncology
Socioeconomic Factors in Health
Surgical Outcomes

Background

Social vulnerability is linked to adverse outcomes in various cancers.
Its impact on soft tissue sarcoma (STS) patients remains understudied.

Purpose Of The Study

To investigate the association between social vulnerability and oncologic outcomes in patients with extremity and truncal soft tissue sarcoma.

Main Methods

A single-institution cohort study analyzed 577 adult patients with primary or recurrent STS.
Social Vulnerability Index (SVI) was used to categorize patients (low vs. high vulnerability).
Kaplan-Meier analysis and Cox regression assessed the impact of SVI on overall survival (OS) and recurrence-free survival (RFS).

Main Results

Patients with high SVI showed trends toward worse OS (p=0.07) and significantly worse RFS (p=0.016).
High SVI was independently associated with shorter RFS (HR 1.64, 95% CI 1.06-2.54) but not OS (HR 1.47, 95% CI 0.84-2.56).
Key demographic and clinical factors were similar between low and high SVI groups.

Conclusions

Community-level social vulnerability is independently associated with worse recurrence-free survival in patients undergoing STS resection.
Patient and community social risk factors should be considered in the management of extremity sarcoma.

Keywords:

Social determinants of health Social vulnerability Soft-tissue sarcoma