Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study

Objectives: As diagnosis and treatment guidelines for bone sarcomas continue updating, it is important to examine whether, when, and which kinds of patients have had a survival improvement over the last four decades. Methods: This cohort study included 9178 patients with primary bone and joint sarco...

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Autores principales:	Xianglin Hu, Kai Deng, Hui Ye, Zhengwang Sun, Wending Huang, Yangbai Sun, Wangjun Yan
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	primary malignant bone and joint tumors bone cancer sarcoma survival time trend Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1811ff3d5cc94dd081f9d03569746b7a
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spelling	oai:doaj.org-article:1811ff3d5cc94dd081f9d03569746b7a2021-11-11T15:29:43ZTrends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study10.3390/cancers132153812072-6694https://doaj.org/article/1811ff3d5cc94dd081f9d03569746b7a2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5381https://doaj.org/toc/2072-6694Objectives: As diagnosis and treatment guidelines for bone sarcomas continue updating, it is important to examine whether, when, and which kinds of patients have had a survival improvement over the last four decades. Methods: This cohort study included 9178 patients with primary bone and joint sarcomas from 1 January 1980 to 31 December 2018 using data from Surveillance, Epidemiology and End Results (SEER)-9 Registries. The follow-up period was extended to November 2020. Patients were divided by decade into four time periods: 1980–1989, 1990–1999, 2000–2009, and 2010–2018. The primary endpoint was bone sarcomas-specific mortality (CSM). The 5-year bone sarcomas-specific survival (CSS) rate was determined stratified by demographic, neoplastic, temporal, economic, and geographic categories. The associations between time periods and CSM were examined using a multivariable Cox regression model, with reported hazard ratio (HR) and 95% confidence interval (CI). Results: The 5-year CSS rate for bone sarcomas was 58.7%, 69.9%, 71.0%, and 69.2%, in the 1980s, 1990s, 2000s, and 2010s, respectively. Older age, male gender, tumor sites at pelvic bones, sacrum, coccyx and associated joints, as well as vertebral column, osteosarcoma and Ewing tumor, and residence in non-metropolitan areas were independently associated with higher CSM risk. After adjusting for the covariates above, patients in the 1990s (HR = 0.74, 95% CI = 0.68–0.82), 2000s (HR = 0.71, 95% CI = 0.65–0.78), and 2010s (HR = 0.68, 95% CI = 0.62–0.76) had significantly lower CSM risks than patients in the 1980s. However, patients in the 2000s and 2010s did not have lower CSM risks than those in the 1990s (both <i>p</i> > 0.05). Conclusions: Although bone sarcomas survival has significantly improved since 1990, it almost halted over the next three decades. Bone sarcomas survival should improve over time, similar to common cancers. New diagnostic and therapeutic strategies such as emerging immune and targeted agents are warranted to overcome this survival stalemate.Xianglin HuKai DengHui YeZhengwang SunWending HuangYangbai SunWangjun YanMDPI AGarticleprimary malignant bone and joint tumorsbone cancersarcomasurvivaltime trendNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5381, p 5381 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	primary malignant bone and joint tumors bone cancer sarcoma survival time trend Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	primary malignant bone and joint tumors bone cancer sarcoma survival time trend Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Xianglin Hu Kai Deng Hui Ye Zhengwang Sun Wending Huang Yangbai Sun Wangjun Yan Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
description	Objectives: As diagnosis and treatment guidelines for bone sarcomas continue updating, it is important to examine whether, when, and which kinds of patients have had a survival improvement over the last four decades. Methods: This cohort study included 9178 patients with primary bone and joint sarcomas from 1 January 1980 to 31 December 2018 using data from Surveillance, Epidemiology and End Results (SEER)-9 Registries. The follow-up period was extended to November 2020. Patients were divided by decade into four time periods: 1980–1989, 1990–1999, 2000–2009, and 2010–2018. The primary endpoint was bone sarcomas-specific mortality (CSM). The 5-year bone sarcomas-specific survival (CSS) rate was determined stratified by demographic, neoplastic, temporal, economic, and geographic categories. The associations between time periods and CSM were examined using a multivariable Cox regression model, with reported hazard ratio (HR) and 95% confidence interval (CI). Results: The 5-year CSS rate for bone sarcomas was 58.7%, 69.9%, 71.0%, and 69.2%, in the 1980s, 1990s, 2000s, and 2010s, respectively. Older age, male gender, tumor sites at pelvic bones, sacrum, coccyx and associated joints, as well as vertebral column, osteosarcoma and Ewing tumor, and residence in non-metropolitan areas were independently associated with higher CSM risk. After adjusting for the covariates above, patients in the 1990s (HR = 0.74, 95% CI = 0.68–0.82), 2000s (HR = 0.71, 95% CI = 0.65–0.78), and 2010s (HR = 0.68, 95% CI = 0.62–0.76) had significantly lower CSM risks than patients in the 1980s. However, patients in the 2000s and 2010s did not have lower CSM risks than those in the 1990s (both <i>p</i> > 0.05). Conclusions: Although bone sarcomas survival has significantly improved since 1990, it almost halted over the next three decades. Bone sarcomas survival should improve over time, similar to common cancers. New diagnostic and therapeutic strategies such as emerging immune and targeted agents are warranted to overcome this survival stalemate.
format	article
author	Xianglin Hu Kai Deng Hui Ye Zhengwang Sun Wending Huang Yangbai Sun Wangjun Yan
author_facet	Xianglin Hu Kai Deng Hui Ye Zhengwang Sun Wending Huang Yangbai Sun Wangjun Yan
author_sort	Xianglin Hu
title	Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
title_short	Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
title_full	Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
title_fullStr	Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
title_full_unstemmed	Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study
title_sort	trends in tumor site-specific survival of bone sarcomas from 1980 to 2018: a surveillance, epidemiology and end results-based study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1811ff3d5cc94dd081f9d03569746b7a
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Trends in Tumor Site-Specific Survival of Bone Sarcomas from 1980 to 2018: A Surveillance, Epidemiology and End Results-Based Study

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