The following article features coverage from the Connective Tissue Oncology Society 2021 virtual meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Lower household income is associated with a greater risk of amputation in adult extremity bone sarcoma, even when patients have health insurance at diagnosis, according to a retrospective study.

The study also showed a greater risk of amputation among patients who were treated at smaller or public hospitals.

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These results were presented at the Connective Tissue Oncology Society (CTOS) 2021 Annual Meeting by Matthew T. Houdek, MD, of the Mayo Clinic in Rochester, Minnesota.

Dr Houdek noted that previous research has shown an increased risk of amputation among patients with lower socioeconomic status. However, there is a lack of data showing the impact of socioeconomic status on patients who have insurance at the time of diagnosis.

With this in mind, Dr Houdek and colleagues evaluated data from 1390 adults with extremity bone sarcoma treated from 2006 to 2017. The data came from the Optum Labs Data Warehouse, a national administrative claims database. All patients had pre-existing health insurance.

Amputation was performed in 18% of patients, and the remaining 82% underwent limb salvage surgery.

Amputation was significantly more likely in patients with household incomes below $75,000 per year (odds ratio [OR], 1.38; 95% CI, 1.03-1.85; P =.03). Conversely, having a household income greater than $125,000 was associated with limb salvage surgery (OR, 0.62; 95% CI, 0.40-0.98; P =.04).

Being treated at a public hospital (OR, 1.41; 95% CI, 1.01-1.97; P =.04) or at a hospital with less than 200 beds (OR, 1.90; 95% CI, 1.20-3.02; P =.006) was significantly associated with amputation rather than limb salvage surgery.

Other factors significantly associated with amputation were:

  • Lower extremity sarcoma (OR, 4.72; 95% CI, 3.37-6.60; P <.001)
  • History of congestive heart failure (OR, 1.71; 95% CI, 1.09-2.69; P =.01)
  • History of coagulopathy (OR, 2.24; 95% CI, 1.51-3.33; P <.001)
  • History of depression (OR, 1.50; 95% CI, 1.05-2.14; P =.02)
  • History of fluid or electrolyte disorder (OR, 1.47; 95% CI, 1.08-2.01; P =.01).

Disclosures: No disclosures were reported.

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Houdek MT, Stuart MB, Wellings EP, et al. Socioeconomic and preoperative risk factors associated with limb salvage versus amputation for adult extremity bone sarcoma patients with medical insurance. Presented at CTOS 2021; November 10-13, 2021. Abstract P026.