439P - Evaluating Ewing’s sarcoma as the prototype for cancer care in teenage and young adults (TYA): A single-center retrospective cross-sectional study

Background

Ewing’s sarcoma and osteosarcoma have high incidence in teenage and young adults (TYA) with age range(15-29 years). This study investigated the epidemiology of cancers among TYA population,with a special emphasis on Ewing’s sarcoma, evaluating theimpact of symptom delay and system delay variables on the patient outcomes.

Methods

This was a single-center, retrospective cross-sectional study conducted between June 2015 and March 2020 on TYA patients with a confirmed diagnosis of cancer. TYA patients registered with Ewing’s sarcoma were selected for the study using a non-probability sampling technique. The symptom delay was defined as >1 month duration from the first symptom to the consultation by primary care physician (PCP). The system delay was defined as >1 month duration from initial consultation by PCP to referring the patient to a dedicated cancer center.

Results

Our study gives a comprehensive overview of cancer epidemiology among TYA patients. Our observation is that 7.35% (450/6120) of our cancer patients are TYAs. Ewing’s sarcoma was found in 8.88% (40/450) of all the TYA cancer patients.Symptom delay was noted among 65.0% of patients and system delay occurred among 57.5% of patients. We observed that symptom delay and system delay at presentation had a significant impact on the patient outcome in terms of increased metastasis and reduced progression free survival. Patients with large tumor volume (>100 cc) had poor Progression Free Survival (PFS), showing a strong negative correlation between tumor volume and PFS. Mean five-year PFS for patients with no detectable metastatic disease at diagnosis was significantly better than for those with metastases (59m vs. 19m, respectively; P<.001). Table: 439P

Correlation of PFS with clinical variables

Conclusions

Ewing’s sarcoma should be considered the prototype of a TYA cancer. Efforts in improving access to healthcare facilities, education of primary healthcare physicians, pediatricians and orthopedic surgeons is of paramount importance to facilitate an early diagnosis and establish care pathways.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.