title: Long-term survivors of childhood bone and soft tissue sarcomas are at risk of hospitalization.
abstract: Childhood cancer survivors can have a high burden of chronic conditions related to cancer treatment, some of which are debilitating or potentially life-threatening. Much remains to be learned about late effects in bone and soft tissue sarcoma survivors.
  
  
  
  The Utah Cancer Registry was used to identify survivors of bone (N = 71) and soft tissue sarcomas (N = 98) who were diagnosed at ages 0-20 years between 1973 and 2007 and were alive at least 5 years after diagnosis. We selected an age-sex-matched comparison cohort (N = 934). Hospitalizations from 1996 to 2012 were extracted from the Utah Department of Health statewide inpatient hospitalization discharge records. Cox, Poisson, and Gamma regressions were used to evaluate the risk of hospitalization, rate of admission, and length of stay for survivors versus the comparison cohort. Primary ICD-9 codes defined the most common reasons for hospitalizations.
  
  
  
  The hazard ratio (HR) of any hospitalization was higher for survivors in reference to the comparison cohort (HR = 2.12, 95% confidence interval [CI] 1.51-2.97). Survivors experienced more hospital admissions (rate ratio [RR] = 4.58, 95% CI 3.92-5.35) and longer length of stay (RR = 1.28, 95% CI 1.12-1.46) compared with the comparison cohort. Survivors treated with any chemotherapy were at three-fold higher risk (HR = 3.37, 95% CI 1.94-5.83) of hospitalization compared with survivors who received surgery and/or radiation alone. Among hospitalized survivors, the most common reason was injury for bone tumor (26.8%) and neoplasm for soft tissue sarcoma (12.2%).
  
  
  
  Childhood survivors of bone tumor and soft tissue sarcoma face ongoing risk of hospitalization for years after diagnosis.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Cristian D
authors.initials: CD
authors.lastname: Gonzalez
authors.affiliation: Sarcoma Services, Huntsman Cancer Institute, Salt Lake City, Utah.|Department of Orthopaedics, University of Utah, Salt Lake City, Utah.
authors.forename: R Lor
authors.initials: RL
authors.lastname: Randall
authors.affiliation: Department of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, Utah.|Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wright
authors.affiliation: Department of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, Utah.
authors.forename: Holly
authors.initials: H
authors.lastname: Spraker-Perlman
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
authors.forename: Jian
authors.initials: J
authors.lastname: Ying
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, Utah.|Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah.|Utah Cancer Registry, Salt Lake City, Utah.
authors.forename: Carol
authors.initials: C
authors.lastname: Sweeney
authors.affiliation: Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah.|Pedigree and Population Resource (Utah Population Database), Huntsman Cancer Institute, Salt Lake City, Utah.|Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah.
authors.forename: Ken R
authors.initials: KR
authors.lastname: Smith
authors.affiliation: Department of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, Utah.|Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, Utah.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D012042:Registries; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D017741:Survivors; D014589:Utah / Q000453:epidemiology
keywords: AYA; Utah Population Database; bone and soft tissue sarcoma; child and adolescent cancer; survivorship