CHILDHOOD CANCER SURVIVORS OF MALIGNANT BONE TUMORS AND SOFT TISSUE SARCOMAS ARE AT RISK OF HOSPITALIZATION

Cristian Gonzalez, BS, BA

Jennifer Wright, MDJian Ying, PhD

Lor Randall, MDAnne Kirchhoff, PhD, MPH

CTOS 2014 Annual Meeting

• Survival rates for children with malignant bone tumors and soft tissue sarcomas (STS) have improved over the past decades.

• Childhood cancer survivors have a high burden of late effects, some of which are debilitating or potentially life threatening.

• Little is known about the impact of late effects on malignant bone tumor and STS survivors’ risk of hospitalization.

INTRODUCTION

1. Determine whether survivors of childhood malignant bone tumors and STS are at an increased risk of hospitalization compared to individuals without cancer.

2. Identify medical reasons for hospitalizations among these survivors compared to individuals without cancer.

3. Evaluate demographic and cancer factors associated with risk of hospitalization among survivors.

OBJECTIVES

• We identified all survivors (≥ 5 years from diagnosis) of malignant bone tumors and STS diagnosed in Utah from 1973-2005. – Limited to age < 21 years old at diagnosis and currently

ages 18-60• A sex and age selected comparison cohort was

identified from the Utah Population Database.• State-wide hospitalizations for both cohorts were

determined using Department of Health hospital discharge records from 1996-2010

METHODS

• Multivariable Cox regression models were used to calculate the rates of hospitalization and Poisson regression models were used to estimate overall risk of any hospitalization for survivors and controls.

• Cox regression models were used to compare the most common reasons for hospitalization in survivors and the comparison cohort.– Primary ICD9 codes

• Demographic and cancer factors associated with hospitalization in survivors were determined.

METHODS

DemographicsRESULTS

RESULTS – AIM1

RESULTS – AIM1

RESULTS – AIM2

RESULTS – AIM 3

Female (vs Male)

70-'79 (vs. 52-69)

80-'94 (vs. 52-69)

5-9 (vs. 0-4)

10-20 (vs. 0-4)

80-'90 (vs. '73-79)

91-'00 (vs. '73-79)

Systemic (vs. Local)

Unknown (vs. Local)

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• The number of hospitalizations and rate of admissions are elevated among childhood cancer survivors of bone tumors and soft tissue sarcomas.

• Neoplasms account for much of the hospital-related morbidity for bone and STS survivors– ? Primary vs secondary malignancies ?

• Efforts to prevent and manage sarcoma and bone tumor survivors’ health problems in outpatient settings could help reduce their hospitalization risk.

SUMMARY

Acknowledgements • Funding:– University of Utah Medical Student Research Program – Primary Children's Medical Center Foundation