(P 82) DISPARITIES IN OSTEOSARCOMA BY SOCIOECONOMIC STATUS

Objective: The influence of socioeconomic status on survival in osteosarcoma has been suggested by large registry studies; however, other studies have not found an association. These studies have relied on varying definitions of socioeconomic status and inclusion criteria. Additionally, they are limited to only variables included in the registries. The objective of this study was to examine the presentation, treatment, and outcomes of patients with osteosarcoma at a single-institution.

Methods: An institutional database identified 71 patients with osteosarcoma diagnosed between 2010-2023. Demographic data including the Area Deprivation Index (ADI) and treatment outcomes were collected from patient records. Patients were stratified by socioeconomic status using 75th percentile and greater representing increased social disadvantage. Survival was compared using Log-rank Test.

Results: Low utilization of outpatient clinics for initial evaluation was found in osteosarcoma (38%) cohorts with high ADI deprivation. Patients with osteosarcoma and high ADI scores had longer median symptoms duration prior to diagnosis compared to low deprivation scores [13.1 weeks (IQR: 6.7-19.2) vs 6.7 weeks (IQR:4.0-11.3), p< 0.01]. High ADI deprivation patients with osteosarcoma needed more additional weeks to complete planned chemotherapy [7.9 (IQR: 6.3 to 11.7) versus the low ADI deprivation group [5.6 weeks (IQR: 3.9 to 9.0) (p=0.012)]. 5-year overall survival (p=0.04) and metastasis free survival (p=0.03) were lower in osteosarcoma patients with ADI > 75th percentile

Conclusion: Measures of socioeconomic disadvantage are associated with presentation, treatment, and survival in pediatric osteosarcoma. Further study is needed to determine whether medical causes or social barriers lead to worse outcomes in this population.