NEW YORK JAN 24, 2008 (Reuters Health) - The treatment and survival of adults with soft-tissue sarcoma of the extremities varies widely by race and ethnicity. Compared with whites, the disease-specific mortality rates are significantly higher in blacks and significantly lower in Asians, according to authors of a paper in the March 1st issue of Cancer.

To examine the effects of race and ethnicity on tumor characteristics and outcomes, Dr. Steve R. Martinez, of University of California at Davis Cancer Center in Sacramento, and colleagues used the Surveillance, Epidemiology, and End Results (SEER) database to identify 6406 patients with extremity soft-tissue sarcoma treated between 1988 and 2003. Included were 4636 whites, 773 blacks, 696 Hispanics, and 411 Asians.

“Hispanics tended to be diagnosed with extremity soft-tissue sarcoma at a younger age than their white, black, and Asian counterparts, which may suggest either a biologic predisposition or an environmental contributing factor for the development of these tumors,” the authors suggest.

Hispanics and blacks were less likely to receive radiation therapy than other groups, despite presentation with larger tumors. Hispanics tended to have higher rates of well-differentiated to moderately differentiated tumors, whereas blacks presented with more poorly differentiated or undifferentiated tumors.

“Hispanics, although they are subject to several of the same socioeconomic factors and exhibit several of the same poor tumor prognostic factors and comorbidities as blacks, displayed a disease-specific survival that, although not significantly superior to whites, clearly trended in that direction,” the investigators report.

There is no simple explanation for the racial and ethnic differences observed in treatment outcomes in patients with primary extremity soft-tissue sarcoma, the researchers state. Genetics, sociodemographics, and access to specialty care all likely play a role.

“The identification of disparities represents a unique opportunity to improve care by addressing the issues leading to the disparities,” Dr. Martinez told Reuters Health.

“Extremity soft tissue sarcomas are rare and can be difficult to diagnose,” he added. “If possible, patients should be referred to a nearby Cancer Center or center of excellence where patients can be treated by a multsidisciplinary team of experts.”

“We are going to narrow our focus to identify potential genetic or epigenetic explanations for the differences in survival noted in this study,” Dr. Martinez said. “In other words, are the survival differences between racial/ethnic populations due to the fact that these populations have, on a genetic and epigenetic level, very different diseases?”

Share This