Faculty Collaboration Database

Age-based disparities in treatment and outcomes of retroperitoneal rhabdomyosarcoma. Int J Clin Oncol 2016 Jun;21(3):602-8

Date

12/10/2015

Pubmed ID

26646222

DOI

10.1007/s10147-015-0918-0

Scopus ID

2-s2.0-84949484118 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Elderly patients (EPs) suffering from retroperitoneal rhabdomyosarcoma (RRMS) carry a considerably poorer prognosis compared to younger patients (YPs). We hypothesized that EPs received less aggressive and comprehensive treatment than YPs, resulting in poorer survival outcomes.

MATERIALS AND METHODS: All patients diagnosed with RRMS since 1998 in the National Cancer Data Base (NCDB) were reviewed for patient demographics, tumor characteristics, treatment modalities and survival outcomes.

RESULTS: Of the 100 patients identified, 35 % were ≥65 years of age. EPs (aged ≥65 years), when compared to YPs (aged <65), were less likely to receive systemic chemotherapy (20 % EPs vs 71 % YPs, p < 0.001) and treatment at an academic center (34 % EPs vs 60 % YPs, p = 0.05), although the frequency of radiation (23 % EPs vs 31 % YPs, p = 0.40) and radical surgery (26 % EPs vs 22 % YPs, p = 0.55) were similar. EPs received treatment more frequently at comprehensive community cancer programs (57 %) and had a shorter median distance of travel for care (6.4 vs 13 miles, p = 0.009). After adjusting for gender and tumor size, EPs had a hazard ratio of 3.6 (95 % CI 1.8-7.2, p < 0.001), with a median survival of 2 months (interquartile range [IQR] 1-8 months) versus 17 months for YPs (IQR 8-43 months).

CONCLUSION: Altered practice patterns exist for EPs and include reduced use of systemic chemotherapy which may contribute to poorer outcomes for RRMS patients. Although regionalization of care poses challenges, this may offer benefit to the EP group.

Author List

Kashtan MA, Jayakrishnan TT, Rajeev R, Charlson JC, Johnston F, Clark Gamblin T, Turaga KK

Authors

John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Adult
Age Factors
Aged
Antineoplastic Agents
Combined Modality Therapy
Databases, Factual
Female
Healthcare Disparities
Humans
Male
Middle Aged
Proportional Hazards Models
Radiotherapy
Retroperitoneal Neoplasms
Rhabdomyosarcoma
Survival Rate
United States