Impact of time to treatment initiation on overall survival for patients with osteosarcoma: A SEER database analysis.

Abstract

e13876 Background: Osteosarcoma is a primary bone tumor that predominantly affects children, adolescents, and young adults. It is typically managed with surgical resection or chemotherapy. There is limited research on the optimal time to treatment interval (TTI) for osteosarcoma in all age groups. The aim of this study is to determine the optimal TTI for osteosarcoma as well as covariates that affect variability in TTI. Methods: Patients from the Surveillance, Epidemiology, and End Results (SEER) database who were diagnosed with Osteosarcoma between 2000-2021 were selected. Additional variables were collected including age, sex, race, stage, surgical status, radiation status, time to treatment, household income, and population size. Cox regression analyses were performed to compare survival. Logistic regression compared factors associated with delayed TTI. Results: A total of 4,750 patients were included. On Cox regression analyses, there was improved survival for patients treated within one month of diagnosis compared to those treated later (p = 0.011; HR = 0.823). Additionally, increased survival was significantly associated with those who were female (p = 0.004; HR = 0.838), underwent surgery (p < 0.001; HR = 0.334), and lived in counties with a median household income > $100,000 (p = 0.050; HR = 0.723). Decreased survival was significantly associated with age 30+ years old (p < 0.001; HR = 2.209), American Indian/Alaska Native patients (p = 0.001; HR = 2.451), regional metastases (p < 0.001; HR = 1.692), distant metastases (p < 0.001; HR = 4.322), chemotherapy (p = 0.024; HR = 1.251) and radiotherapy (p < 0.001; HR = 1.473). On logistic regression, delayed TTI was associated with patients aged 10-29 years old (p < 0.001; OR = 2.472), patients aged 30+ years old (p < 0.001; OR = 7.385), Black (p = 0.009; OR = 1.396), or Hispanic patients (p < 0.001; OR = 1.450), while those with distant metastases (p < 0.001; OR = 0.597), underwent surgery (p < 0.001; OR = 0.585), or chemotherapy (p < 0.001; OR = 0.441) had earlier time to treatment. Conclusions: Earlier onset of treatment within one month of diagnosis was associated with significantly improved survival for patients with osteosarcoma. Delayed TTI were associated with those aged 10+ years old and of African American or Hispanic descent. Awareness of the factors that affect survivability and delayed TTI is critical for outcomes. Future research should focus on addressing the demographic disparities in osteosarcoma treatment and survival outcomes.