Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Demographics and Tumor-Specific Variables
2.3. Treatment Data
2.4. Outcomes of Interest and Statistical Analysis
3. Results
3.1. Vertebral Osteosarcomas
3.2. Sacral and Pelvic Osteosarcomas
4. Discussion
4.1. Demographic and Socioeconomic Factors
4.2. Tumor Characteristics
4.3. Treatment
4.4. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Vertebral (n = 32) | Sacropelvic (n = 175) | |||
---|---|---|---|---|---|
n (%) or Median (IQR) | Missing Data (%) | n (%) or Median (IQR) | Missing Data (%) | ||
Year of Diagnosis | 2008 | 2 (6.2%) | - | 16 (9.1%) | 0 (0%) |
2009 | 2 (6.2%) | 9 (5.1%) | |||
2010 | 2 (6.2%) | 17 (9.7%) | |||
2011 | 4 (12.5%) | 23 (13.1%) | |||
2012 | 2 (6.2%) | 10 (5.7%) | |||
2013 | 5 (15.6%) | 13 (7.4%) | |||
2014 | - | 9 (5.1%) | |||
2015 | 5 (15.6%) | 22 (12.6%) | |||
2016 | 4 (12.5%) | 22 (12.6%) | |||
2017 | 4 (12.5%) | 15 (8.6%) | |||
2018 | 2 (6.2%) | 19 (10.9%) | |||
Age | 15 (12.75–19) | - | 17 (14–19) | - | |
Age Category | 0–10 | 6 (18.8%) | - | 22 (12.6%) | 0 (0%) |
11–15 | 13 (40.6%) | 59 (33.7%) | |||
16–21 | 13 (40.6%) | 94 (53.7%) | |||
Sex | Male | 12 (37.5%) | - | 102 (58.3%) | 0 (0%) |
Female | 20 (62.5%) | 73 (41.7%) | |||
Race | White | 25 (78.1%) | - | 126 (72%) | 0 (0%) |
Black | 4 (12.5%) | 37 (21.1%) | |||
Other | 3 (9.4%) | 12 (6.9%) | |||
Hispanic Ethnicity | No | 29 (90.6%) | - | 144 (85.2%) | 6 (3.4%) |
Yes | 3 (9.4%) | 25 (14.8%) | |||
Insurance Status | Private insurance | 20 (66.7%) | 2 (6.2%) | 98 (58.3%) | 7 (4%) |
Government | 10 (33.3%) | 65 (38.7%) | |||
Not insured | - | 5 (3%) | |||
Percentage of non-High School Graduates by Zip Code | ≤10.8% | 15 (57.7%) | 6 (18.8%) | 76 (47.2%) | 14 (8%) |
>10.8% | 11 (42.3%) | 85 (52.8%) | |||
Median Income by Zip Code | >$50,333 | 10 (38.5%) | 6 (18.8%) | 69 (42.9%) | 14 (8%) |
≤$50,333 | 16 (61.5%) | 92 (57.1%) | |||
Residing Population Size | ≥250,000 | 20 (66.7%) | 2 (6.2%) | 138 (85.2%) | 13 (7.4%) |
<250,000 | 10 (33.3%) | 24 (14.8%) | |||
Charlson-Deyo Score | 0 | 31 (96.9%) | - | 157 (89.7%) | 0 (0%) |
≥1 | 1 (3.1%) | 18 (10.3%) | |||
Maximum Tumor Dimension | ≤8 cm | 20 (64.5%) | 1 (3.1%) | 47 (30.7%) | 22 (12.6%) |
>8 cm | 11 (35.5%) | 106 (69.3%) | |||
Grade | Grade 1–2 | 14 (43.8%) | - | 31 (19.6%) | 17 (9.7%) |
Grade 3–4 | 18 (56.2%) | 127 (80.4%) | |||
Regional Lymph Node Involvement | No | 29 (90.6%) | - | 147 (95.5%) | 21 (12%) |
Yes | 3 (9.4%) | 7 (4.5%) | |||
Distant Metastasis | No | 27 (84.4%) | - | 124 (77.5%) | 15 (8.6%) |
Yes | 5 (15.6%) | 36 (22.5%) | |||
Stage | Stage I | 14 (43.8%) | - | 31 (19.9%) | 19 (10.9%) |
Stage II | 10 (31.2%) | 82 (52.6%) | |||
Stage III–IV | 8 (25%) | 43 (27.6%) | |||
Surgery | No | 4 (12.5%) | - | 80 (45.7%) | 0 (0%) |
Yes | 28 (87.5%) | 95 (54.3%) | |||
Residual Tumor * | No residual tumor | 14 (53.8%) | 2 (7.1%) | 60 (75%) | 15 (15.8%) |
Residual tumor | 12 (46.2%) | 20 (25%) | |||
Radiotherapy | No | 21 (67.7%) | 1 (3.1%) | 145 (84.8%) | 4 (2.3%) |
Yes | 10 (32.3%) | 26 (15.2%) | |||
Chemotherapy | No | 7 (21.9%) | - | 12 (6.9%) | 2 (1.1%) |
Yes | 25 (78.1%) | 161 (93.1%) | |||
Treatment Combinations | S + CT + RT | 8 (25.8%) | 1 (3.1%) | 7 (4.3%) | 14 (8%) |
S + CT | 12 (38.7%) | 82 (50.9%) | |||
S + RT | 1 (3.2%) | - | |||
CT + RT | 1 (3.2%) | 19 (11.8%) | |||
S only | 6 (19.4%) | 4 (2.5%) | |||
CT only | 3 (9.7%) | 49 (30.4%) | |||
RT only | - | - | |||
Length of Stay * | 5 (3–7.5) | 1 (3.6%) | 11 (6.8–20) | 19 (20%) | |
Unplanned Readmission * | No | 24 (85.7%) | - | 87 (95.6%) | 4 (4.2%) |
Yes | 4 (14.3%) | 4 (4.4%) | |||
1-Year Survival | No | 3 (10.3%) | 3 (9.4%) | 38 (22.9%) | 9 (5.1%) |
Yes | 26 (89.7%) | 128 (77.1%) | |||
3-Year Survival | No | 10 (38.5%) | 6 (18.8%) | 77 (52.7%) | 29 (16.6%) |
Yes | 16 (61.5%) | 69 (47.3%) | |||
5-Year Survival | No | 12 (63.2%) | 13 (40.6%) | 86 (67.7%) | 48 (27.4%) |
Yes | 7 (36.8%) | 41 (32.3%) | |||
10-Year Survival | No | 12 (92.3%) | 19 (59.4%) | 90 (91.8%) | 77 (44%) |
Yes | 1 (7.7%) | 8 (8.2%) |
Variable | Vertebral | Sacropelvic | ||||
---|---|---|---|---|---|---|
Odds Ratio (95% CI) | p Value | Odds Ratio (95% CI) | p Value | |||
Univariate Logistic Regression | Age | 0–10 | Reference | Reference | ||
11–15 | 2.4 (0.084–69.428) | 0.562 | 0.635 (0.215–1.744) | 0.389 | ||
16–21 | 1.1 (0.045–14.418) | 0.943 | 0.447 (0.158–1.162) | 0.109 | ||
Sex | Male | Reference | Reference | |||
Female | 0.515 (0.024–4.63) | 0.586 | 0.645 (0.351–1.179) | 0.155 | ||
Race | White | Reference | Reference | |||
Black | 0.409 (0.035–9.73) | 0.495 | 0.844 (0.404–1.768) | 0.652 | ||
Other | NA (0–Inf) | 0.996 | 0.800 (0.238–2.687) | 0.712 | ||
Hispanic Ethnicity | No | Reference | Reference | |||
Yes | 0.037 (0.001–0.536) | 0.021 | 0.317 (0.123–0.752) | 0.012 | ||
Insurance Status | Private insurance | Reference | Reference | |||
Government | NA (0–Inf) | 0.996 | 0.585 (0.314–1.081) | 0.088 | ||
Not insured | - | 2.780 (0.394–55.436) | 0.368 | |||
Percentage of non-High School Graduates by Zip Code | ≤10.8% | Reference | Reference | |||
>10.8% | 0.647 (0.069–6.045) | 0.685 | 0.436 (0.235–0.798) | 0.008 | ||
Median Household Income by Zip Code | >$50,333 | Reference | Reference | |||
≤$50,333 | 1.941 (0.216–42.063) | 0.586 | 0.583 (0.317–1.066) | 0.081 | ||
Residing Population Size | ≥250,000 | Reference | Reference | |||
<250,000 | NA (0–Inf) | 0.996 | 0.682 (0.291–1.574) | 0.369 | ||
Charlson-Deyo Score | 0 | Reference | Reference | |||
≥1 | NA (0–Inf) | 0.995 | 0.826 (0.307–2.222) | 0.7 | ||
Maximum Tumor Dimension | ≤8 cm | Reference | Reference | |||
>8 cm | 0.158 (0.007–1.426) | 0.131 | 0.613 (0.310–1.187) | 0.151 | ||
Grade | Grades 1–2 | Reference | Reference | |||
Grades 3–4 | 0.385 (0.018–3.431) | 0.432 | 0.704 (0.327–1.475) | 0.358 | ||
Regional Lymph Node Involvement | No | Reference | Reference | |||
Yes | 0.231 (0.016–5.819) | 0.284 | 0.620 (0.119–2.892) | 0.539 | ||
Distant Metastasis | No | Reference | Reference | |||
Yes | 0.12 (0.01–1.285) | 0.07 | 0.165 (0.069–0.363) | <0.001 | ||
Multivariate Logistic Regression | Age Category | 0–10 | - | Reference | ||
11–15 | 0.693 (0.213–2.094) | 0.525 | ||||
16–21 | 0.565 (0.182–1.621) | 0.302 | ||||
Sex | Male | - | Reference | |||
Female | 0.827 (0.412–1.667) | 0.592 | ||||
Hispanic Ethnicity | No | Reference | Reference | |||
Yes | NA (0–Inf) | 0.996 | 0.342 (0.115–0.941) | 0.043 | ||
Insurance Status | Private insurance | - | Reference | |||
Government | 0.851 (0.413–1.771) | 0.664 | ||||
Not insured | 4.402 (0.525–98.341) | 0.227 | ||||
Percentage of non-High School Graduates by Zip Code | ≤10.8% | - | Reference | |||
>10.8% | 0.525 (0.202–1.346) | 0.18 | ||||
Median Household Income by Zip Code | >$50,333 | - | Reference | |||
≤$50,333 | 1.389 (0.553–3.608) | 0.489 | ||||
Maximum Tumor Dimension | ≤8 cm | Reference | Reference | |||
>8 cm | NA (0–Inf) | 0.996 | 0.606 (0.279–1.281) | 0.196 | ||
Distant Metastasis | No | Reference | Reference | |||
Yes | 0.336 (0.008–18.286) | 0.541 | 0.173 (0.068–0.407) | <0.001 |
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Jagtiani, P.; Karabacak, M.; Carr, M.T.; Bahadir, Z.; Morgenstern, P.F.; Margetis, K. Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes. Children 2024, 11, 1025. https://doi.org/10.3390/children11081025
Jagtiani P, Karabacak M, Carr MT, Bahadir Z, Morgenstern PF, Margetis K. Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes. Children. 2024; 11(8):1025. https://doi.org/10.3390/children11081025
Chicago/Turabian StyleJagtiani, Pemla, Mert Karabacak, Matthew T. Carr, Zeynep Bahadir, Peter F. Morgenstern, and Konstantinos Margetis. 2024. "Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes" Children 11, no. 8: 1025. https://doi.org/10.3390/children11081025