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Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment
Pemla Jagtiani1, Mert Karabacak2, Matthew T Carr2
1School of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA.
Insights
This study analyzed pediatric vertebral, sacral, and pelvic osteosarcomas using National Cancer Database (NCDB) data. Key findings include factors influencing mortality and treatment, emphasizing personalized care for better outcomes.
Area of Science:
- Pediatric Oncology
- Skeletal Oncology
- Cancer Epidemiology
Background:
- Osteosarcomas of the spine and pelvis are rare pediatric malignancies.
- Understanding their epidemiology and treatment is crucial for improving survival.
Purpose of the Study:
- To investigate the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral, and pelvic osteosarcomas.
- To identify prognostic factors affecting patient outcomes.
Main Methods:
- Retrospective review of National Cancer Database (NCDB) data from 2008-2018.
- Analysis included patients aged 0-21 years with vertebral, sacral, or pelvic osteosarcomas.
- Statistical methods included logistic regression, Poisson regression, Kaplan-Meier estimates, and Cox proportional hazards models.
Main Results:
- For vertebral osteosarcomas, lymph node involvement and distant metastasis significantly increased mortality hazard.
- For sacral and pelvic osteosarcomas, no residual tumor and radiotherapy receipt were associated with lower mortality.
- Distant metastasis was a strong predictor of mortality; Hispanic ethnicity was linked to lower resection odds.
Conclusions:
- NCDB data provides valuable insights into pediatric vertebral, sacral, and pelvic osteosarcomas.
- Prognostic factors like metastasis and residual disease impact survival.
- Personalized treatment approaches are essential for optimizing outcomes in these rare tumors.
Background And Objectives:
Retrieve data from the National Cancer Database (NCDB) to examine information on the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral and pelvic osteosarcomas.
Methods:
We reviewed NCDB data from 2008 to 2018, concentrating on vertebral, sacral, and pelvic osteosarcomas in children 0 to 21 years. Our analysis involved logistic and Poisson regression, Kaplan-Meier survival estimates, and Cox proportional hazards models.
Results:
The study population included 207 patients. For vertebral osteosarcomas, 62.5% of patients were female, and 78.1% were white. Regional lymph node involvement predicted 80 times higher mortality hazard (p = 0.021). Distant metastasis predicted 25 times higher mortality hazard (p = 0.027). For sacral and pelvic osteosarcomas, 58.3% of patients were male, and 72% were white. Patients with residual tumor were 4 times more likely to have prolonged LOS (p = 0.031). No residual tumor (HR = 0.53, p = 0.03) and radiotherapy receipt (HR = 0.46, p = 0.034) were associated with lower mortality hazards. Distant metastasis predicted 3 times higher mortality hazard (p < 0.001). Hispanic ethnicity was linked to lower resection odds (OR = 0.342, p = 0.043), possibly due to language barriers affecting patient understanding and care decisions.
Conclusions:
In conclusion, our examination of NCDB offers a thorough exploration of demographics, treatment patterns, and results, highlighting the importance of personalized approaches to enhance patient outcomes.
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