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What Factors Influence Chemotherapy Treatment Rate in Patients with Upper Limb Osteosarcoma?
David Jose Restrepo, MD1, Gabriela Cinotto, MD2, Maria T Huayllani, MD2, Daniel Boczar, MD2, Aaron C Spaulding, PhD1, Oscar J Manrique, MD3 and Antonio Jorge Forte, MD2, (1)Mayo Clinic, Jacksonville, FL, (2)Mayo Clinic Florida, Jacksonville, FL, (3)Mayo Clinic, Rochester, MN

Background: Although chemotherapy is the mainstay treatment for osteosarcoma, some patients do not receive it. The purpose of this study is to elucidate the factors that predispose patients with osteosarcoma to not receiving chemotherapy.

Methods: In this retrospective cohort study, we queried the National Cancer Data Base for bone cancer patients diagnosed between January 1st, 2004 and December 31st, 2015. We included patients of any age and sex diagnosed with osteosarcoma of the upper extremities. With bivariate and multivariate models, we analyzed the demographic, facility, and tumor-specific characteristics, comparing the group that received chemotherapy with the group that did not receive chemotherapy.

Results: Multivariate analysis showed that age groups 21 to 40 years (odds ratio [OR], 0.281; 95% CI, 0.129-0.613), 41 to 60 years (OR, 0.103; 95% CI, 0.045-0.238), and 61 years or older (OR, 0.03; 95% CI, 0.012-0.071) had lower odds of receiving chemotherapy treatment than patients younger than 21 years. Female patients (OR, 0.567; 95% CI, 0.337-0.955), non-White patients (OR, 0.485; 95% CI, 0.25-0.939), and patients with government insurance (OR, 0.506; 95% CI, 0.285-0.9) had lower odds of receiving chemotherapy treatment than male, white, and privately insured patients. Stages II (OR, 4.817; 95% CI, 2.594-8.946) and IV (OR, 0.457; 95% CI, 1.931-10.286) had higher odds of receiving chemotherapy than stage I disease.

Conclusion: Patients with osteosarcoma of the upper extremities benefit from treatment with chemotherapy. Large prospective analyses are needed to understand which factors affect the receipt of chemotherapy in patients with upper-extremity osteosarcoma.

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