Impact of demographics on surveillance and survival in post-resection orthopedic Sarcoma patients.

Purpose: This study aims to evaluate the impact of race, socioeconomic deprivation, and insurance status on adherence to imaging surveillance within five years following the diagnosis and resection of sarcoma of the bone. It also examines how these factors relate to cancer-related mortality.

Patients and methods: A retrospective cohort study evaluated the relationship between demographics and surveillance imaging adherence among primary bone tumor (PBT) patients at a single institution. Out of 128 patients diagnosed with and surgically managed for a PBT between 2013 and 2018, 91 were chosen for analysis after excluding for metastatic disease at the time of resection and insufficient surveillance data. Surveillance data was collected from patients who were monitored for five years post-resection or until metastasis occurred, with adherence to surveillance imaging protocols and survival assessed over this period.

Results: The cohort comprised 91 patients (56 % male, 44 % female; 71 % White, 24 % Black or African American). Under-represented minority (URM) status was associated with 0.19 odds of receiving optimal imaging adherence (95 % CI [0.05, 0.71], P = .01). Furthermore, URM patients had 3.20 odds of mortality compared to White patients during the five-year follow-up (95 % CI [1.18, 8.67], P = .02).

Conclusion: At our institution, URM patients demonstrate significantly lower adherence to imaging surveillance and higher mortality rates following primary sarcoma resection. These findings highlight the necessity for targeted interventions to address societal and health system factors that contribute to disparities in imaging adherence and survival among URM patients.