Sex differences in osteosarcoma survival across the age spectrum: A National Cancer Database analysis (2004–2016)

• Published in: Cancer epidemiology 2024-10, Vol.92, p.102565, Article 102565
• Main Authors: Williams, Lindsay A., Barragan, Sofia, Lu, Zhanni, Weigel, Brenda J., Spector, Logan G.
• Format: Article
• Language: English
• Subjects: Age groups; Bone cancer; Cancer therapies; Chemotherapy; Childhood and adult cancer; Death; Education; Ethnicity; Females; Gender differences; Males; Medicare; Metastases; Metastasis; Osteosarcoma; Pediatrics; Postal codes; Radiation; Secondary schools; Sex differences; Surgery; Survival; Tumors
• ISSN: 1877-7821; 1877-783X; 1877-783X
• DOI: 10.1016/j.canep.2024.102565

Osteosarcoma displays a bimodal peak in incidence in adolescence and later adulthood. Males are more frequently diagnosed with osteosarcoma in both periods. Males have worse survival than females, which is generally poor at 30–70% 5-years post diagnosis, depending on age, but treatment received is often unaccounted for in survival analyses. Therefore, we estimated sex differences in survival for children and adults stratifying by treatment received and other disease characteristics using the National Cancer Database (2004–2016, n=9017). We estimated sex differences in long-term survival using Kaplan Meier survival curves and Log-Rank p-values. We also estimated hazard ratios (HR) and 95% confidence intervals (CIs) as the measure of association between sex and death using Cox regression. In all age groups, cases were predominantly male (52–58%). In Kaplan-Meier analyses, males had worse overall survival than females for 0–19, 20–39, and ≥60-year-olds (Log-Rank p