Receipt of Guideline-Concordant Care is Associated with Improved Survival in Patients with Osteosarcoma in California: a Population-Based Analysis

Details

• Alternative Title:
  JCO Oncol Pract
• Personal Author:
  Abrahão, Renata ; Keegan, Theresa H.M. ; Maguire, Frances B. ; Li, Qian ; Malogolowkin, Marcio H. ; Wong, Samantha ; Thorpe, Steven W. ; Carr-Asher, Janai R. ; Midboe, Amanda M. ; Randall, Lor L. ; Alvarez, Elysia M.
• Description:
  PURPOSE
  
  To examine the relationship between guideline-concordant care (GCC) based on national clinical practice guidelines and survival in children (0–14 years), adolescents and young adults (AYAs, 15–39 years), and adults (≥40 years) with osteosarcoma; and to identify sociodemographic and clinical factors associated with receipt of GCC and survival.
  
  METHODS
  
  We used data from the California Cancer Registry (CCR) on patients diagnosed with osteosarcoma during 2004–2019, with detailed treatment information extracted from the CCR text fields, including chemotherapy regimens. Multivariable logistic and Cox proportional hazard regression were used for statistical analyses.
  
  RESULTS
  
  Of 1,716 patients, only 47% received GCC, with variation by age at diagnosis: 67% of children, 43% of AYAs, and 30% of adults. In multivariable models, patients who received part or all care (vs none) at specialized cancer centers were more likely to receive GCC. AYAs and adults were less likely to receive GCC than children ((Odds Ratio (OR)=0.38, 95% Confidence Interval (CI) 0.30–0.50 and OR=0.40, CI 0.28–0.56, respectively). In a model excluding adults, patients treated by pediatric (vs medical) oncologists were more likely to receive GCC (OR=3.44, CI 2.40–4.94). Patients with metastatic osteosarcoma at diagnosis who did not receive GCC had a greater hazard of death (Hazard Ratio (HR)=2.02, CI 1.55–2.63), but no statistical differences were found in those diagnosed at earlier stages (HR=1.15, CI 0.92–1.43).
  
  CONCLUSIONS
  
  GCC was associated with improved survival in patients with metastatic osteosarcoma in California. However, we found disparities in the delivery of GCC, highlighting the need for target interventions to improve delivery of GCC in this patient population.
  
  
• Subjects:
  Adolescent Adult Bone Neoplasms California Child Child, Preschool Female Guideline Adherence Humans Infant Infant, Newborn Male Middle Aged Osteosarcoma Practice Guidelines As Topic Young Adult

  More +
• Keywords:
  Adolescents And Young Adults Adults Children Guideline-concordant Care Population-based Specialized Cancer Center
• Source:
  JCO Oncol Pract. 20(8):1064-1074
• DOI:
  http://dx.doi.org/10.1200/OP.23.00591
• Pubmed ID:
  38381995
• Pubmed Central ID:
  PMC11747934
• Document Type:
  Journal Article
• Funding:
  HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; P30 CA093373/CA/NCI NIH HHSUnited States/
• Volume:
  20
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:f657397b1fe88e1ba2532eb56d4a23fa373226b832f001532a092153505290eaea1c220dd0ceebf1cd2e11d0feac36755349bb06d05ff3a678cdbac1f6611cbb
• Download URL:
  https://stacks.cdc.gov/view/cdc/175931/cdc_175931_DS1.pdf
• File Type:
  [PDF - 702.97 KB ]