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Abstract
Background: Soft tissue sarcomas (STS) are malignant tumors that originate in soft tissues, managed with surgical resection as first-line treatment. Time to intervention (TTI) is crucial to the overall survival as metastases can develop in about 50% of STS patients. In the US, the median TTI is 22 days for STS patients, with longer TTI associated with poorer outcomes.1-3 While low-income public insurance and academic centers have individually been associated with increased TTI, no studies have investigated the combined impact of these factors.2,4-5.
Methods: We performed a single academic institution retrospective chart review of patients who underwent surgical STS resection between 2013 and 2023 with Medicaid or Medicare insurance. TTI was calculated from date of diagnosis to date of surgical resection.
Results: Data was collected from 69 patients who underwent surgical STS resection; 20 patients were diagnosed and referred from outside hospitals, and 28 patients received preoperative radiation therapy (PRT). 90% of STS patients were diagnosed by biopsy and 10% by imaging. The most common STS diagnoses included “undifferentiated pleomorphic sarcoma” (25%) and “myxofibrosarcoma” (20%). Of the 41 patients that underwent STS surgical resection only, 56% had high grade (grade 2 or 3) STS and had a median TTI of 40 days. Among the PRT patients, 89% had high grade STS and median TTI of 104 days.
Conclusion: The median TTI for surgical resection of STS in Medicare and Medicaid patients at a single academic institution was higher compared to the median TTI for STS in the US.