title: Comparison of Latino and non-Latino patients with Ewing sarcoma.
abstract: BACKGROUND
  Ewing sarcoma (ES) is a malignancy of bone and soft tissue in children and adults. Previous registry-based studies indicate that Latino patients with ES have inferior outcomes compared to non-Latino patients, though an etiology for this difference could not be identified. To explore possible differences that might underlie this disparity, we conducted a retrospective study to compare clinical characteristics, tumor features, healthcare access, and treatment outcomes between Latino and non-Latino patients with ES.
  
  
  METHODS
  Primary data for 218 ES patients treated at two academic medical centers between 1980 and 2010 were collected. Categorical data were compared using Fisher exact tests; Wilcoxon rank-sum tests were used for continuous variables. Survival was estimated using Kaplan-Meier analysis and compared using log-rank testing.
  
  
  RESULTS
  Latino patients were diagnosed at a younger age (P = 0.014). All other clinical and histological data were similar between groups, including radiologic and histologic response to neoadjuvant chemotherapy. Latino patients had lower socioeconomic status (P = 0.001), were less likely to have insurance (P = 0.001), and were more likely to present to the emergency room at onset of symptoms (P = 0.031) rather than to primary care physicians. Five-year event free survival (EFS) and overall survival (OS) were similar between Latino and non-Latino patients (EFS: 60.5% vs. 50.9% P = 0.37; OS: 77.6% vs. 68.6% P = 0.54).
  
  
  CONCLUSIONS
  Latino patients with ES present at a younger age, and have evidence of impaired access to healthcare. Response to initial therapy appears similar between Latino and non-Latino patients.
authors: Department of Pediatrics, San Francisco School of Medicine, University of California, San Francisco, California; Department of Pathology, San Francisco School of Medicine, University of California, San Francisco, California.
authors: Jeremy
authors: J
authors: Sharib
authors: Andrew
authors: A
authors: Horvai
authors: Florette K
authors: FK
authors: Gray Hazard
authors: Heike
authors: H
authors: Daldrup-Link
authors: Robert
authors: R
authors: Goldsby
authors: Neyssa
authors: N
authors: Marina
authors: Steven G
authors: SG
authors: DuBois
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002648:Child; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D012959:Socioeconomic Factors; D015996:Survival Rate; D055815:Young Adult
keywords: Ewing sarcoma; Latino; cancer disparities; ethnicity; hispanic
references: Cancer. 2009 Aug 1;115(15):3526-36
references: 19548262
references: Pediatrics. 2009 Oct;124(4):e688-96
references: 19786429
references: Cancer. 2008 May 1;112(9):2011-20
references: 18361399
references: Fetal Pediatr Pathol. 2013 Jul;32(4):246-52
references: 23043418
references: Cancer. 2006 Oct 15;107(8):1711-42
references: 16958083
references: Mol Cell Biol. 1993 Dec;13(12):7393-8
references: 8246959
references: Cancer Epidemiol Biomarkers Prev. 2009 Feb;18(2):611-5
references: 19208664
references: Cancer. 2010 Feb 15;116(4):983-8
references: 20052725
references: Br J Cancer. 2001 Nov 30;85(11):1646-54
references: 11742482
references: J Clin Oncol. 2000 Jan;18(1):4-11
references: 10623687
references: Cancer Causes Control. 2001 Oct;12(8):703-11
references: 11562110
references: Int J Cancer Suppl. 1998;11:56-61
references: 9876480
references: J Clin Oncol. 2002 Apr 15;20(8):2109-17
references: 11956272
references: Eur J Cancer. 2009 Jan;45(2):228-47
references: 19097774
references: J Clin Oncol. 2010 Apr 20;28(12):1982-8
references: 20308673
references: Pediatr Blood Cancer. 2011 Jun;56(6):994-1002
references: 21328525
references: Int J Cancer. 2008 Oct 1;123(7):1499-507
references: 18646185
references: J Clin Oncol. 2000 Sep;18(17):3108-14
references: 10963639
references: Nat Genet. 2012 Feb 12;44(3):323-7
references: 22327514
references: J Bone Joint Surg Am. 2000 May;82(5):667-74
references: 10819277
references: JAMA. 2003 Oct 15;290(15):2008-14
references: 14559954
references: Ann Oncol. 2002 Oct;13(10):1656-64
references: 12377657
references: Oncologist. 2006 Jun;11(6):590-601
references: 16794238
references: Cancer. 2008 Nov 1;113(9):2575-96
references: 18837040
references: Int J Cancer. 1993 Feb 1;53(3):371-6
references: 8428791
references: Cancer. 2009 Aug 15;115(16):3808-16
references: 19484783
references: CA Cancer J Clin. 2004 Mar-Apr;54(2):78-93
references: 15061598
references: Cancer. 1991 Jan 1;67(1):163-71
references: 1985713
references: J Pediatr Hematol Oncol. 2008 Jun;30(6):425-30
references: 18525458
references: Lancet Oncol. 2010 Feb;11(2):184-92
references: 20152770
references: J Clin Oncol. 2007 Oct 10;25(29):4610-5
references: 17925556
references: J Clin Oncol. 2010 Sep 20;28(27):4135-41
references: 20697082
references: Int J Cancer. 2011 Mar 1;128(5):1139-50
references: 20473914
references: Cancer. 2010 Apr 15;116(8):1964-73
references: 20151425
references: J Clin Oncol. 2011 Jan 1;29(1):76-82
references: 21098321
references: Clin Sarcoma Res. 2012 Feb 08;2(1):7
references: 22587879
references: Cancer. 2007 Feb 1;109(3):603-11
references: 17177205
references: South Med J. 2010 Jun;103(6):509-16
references: 20710132
references: CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66
references: 17237035
references: Am J Respir Crit Care Med. 2010 Nov 1;182(9):1195-205
references: 21041563
references: Cancer. 2011 Jan 1;117(1):152-61
references: 20737564
references: J Clin Oncol. 1997 Apr;15(4):1553-9
references: 9193352
references: Cancer Res. 2010 May 1;70(9):3730-8
references: 20388798