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Impact of treatment refusal and abandonment on survival outcomes in pediatric osteosarcoma in Southeast Asia: A multicenter study.

التفاصيل البيبلوغرافية
العنوان: Impact of treatment refusal and abandonment on survival outcomes in pediatric osteosarcoma in Southeast Asia: A multicenter study.
المؤلفون: Monsereenusorn C; Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand., Alcasabas AP; Section of Hematology-Oncology, Department of Pediatrics, University of the Philippines - Philippine General Hospital, Manila, Philippines., Loh AHP; Department of Pediatric Surgery, KK Women's and Children's Hospital, Singapore.; Duke-NUS Medical School, Singapore., Soh SY; Duke-NUS Medical School, Singapore.; Haematology/Oncology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore., Leung KWP; Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore., Kimpo M; Division of Pediatric Hematology/Oncology & Bone Marrow and Cord Blood Transplantation, University Children's Medical Institute, National University Hospital, Singapore., Dhamne C; Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India., Blair S; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Lam C; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Photia A; Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand., Rujkijyanont P; Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand., Traivaree C; Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand., Pairojboriboon S; Department of Orthopaedic Surgery, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand., Rodriguez-Galindo C; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
مؤلفون مشاركون: Asian Childhood Cancer Alliance Osteosarcoma Study Group
المصدر: Pediatric blood & cancer [Pediatr Blood Cancer] 2022 Apr; Vol. 69 (4), pp. e29556. Date of Electronic Publication: 2022 Jan 17.
نوع المنشور: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hoboken, N.J. : John Wiley, c 2004-
مواضيع طبية MeSH: Bone Neoplasms*/pathology , Osteosarcoma*/pathology, Asia, Southeastern/epidemiology ; Child ; Humans ; Retrospective Studies ; Treatment Refusal
مستخلص: Background: Treatment refusal and abandonment (TxRA) are major barriers to improving outcomes among children with sarcomas of the extremities as curative treatment options bearing on amputation or disfiguring surgery, particularly in countries with limited resources. A multi-institutional retrospective study was conducted to determine the predictive factors for TxRA among patients with osteosarcoma associated with survival outcomes across Southeast Asia (SEA).
Methods: Pediatric patients with osteosarcoma treated between January 1998 and December 2017 in four SEA pediatric oncology centers from three countries were studied. Nelson-Aalen estimates, Kaplan-Meier method, and Cox's proportion hazard model were applied to address the cumulative incidence, survival outcomes, and to identify prognostic factors associated with TxRA.
Results: From a total of 208 patients with osteosarcoma enrolled; 18 (8.7%) patients refused and 41 (19.7%) patients abandoned treatment. Income classification of countries, age at diagnosis, tumor size, disease extent, chemotherapy protocols, and types of surgery were associated with TxRA. Tumor size more than 15 cm was an independent risk factor associated with TxRA. The 5-year overall and relapse-free survivals were 49.4% and 50.4%, respectively. However, these rates declined further to 37.9% and 35.8%, respectively, when TxRA were considered as events. Tumor size larger than 15 cm and metastatic disease were independent risk factors associated with TxRA-sensitive outcomes.
Conclusion: The prevalence of TxRA was high in SEA, particularly in lower middle-income countries. Factors associated with TxRA related to tumor burden. Treatment outcomes could be substantially improved by lowering the refusal and abandonment rates.
(© 2022 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: Southeast Asia; abandonment; metastatic disease; osteosarcoma; outcomes; tumor size
تواريخ الأحداث: Date Created: 20220117 Date Completed: 20220504 Latest Revision: 20220504
رمز التحديث: 20221213
DOI: 10.1002/pbc.29556
PMID: 35038209
قاعدة البيانات: MEDLINE
الوصف
تدمد:1545-5017
DOI:10.1002/pbc.29556