Table 3.
Hazard ratios for survival adjusted for by propensity analysis
| Total | Limb Salvage (n = 1316) | Amputation (n = 409) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| HR | P | 95% CI | HR | P | 95% CI | HR | P | 95% CI | |
| Surgery Type | 0.71 | 0.000 | 0.59–0.85 | 1.42 | 0.001 | 1.13–1.63 | |||
| Age; median (IQR) | 1.02 | 0.000 | 1.01–1.02 | 1.02 | 0.000 | 1.01–1.02 | 1.01 | 0.001 | 1.01–1.02 |
| < 20 | Reference | ||||||||
| 20–39 | 1.15 | 0.195 | 0.93–1.42 | 1.11 | 0.413 | 0.86–1.44 | 1.12 | 0.549 | 0.77–1.64 |
| 40–59 | 1.29 | 0.056 | 0.99–1.67 | 1.33 | 0.076 | 0.97–1.82 | 1.20 | 0.446 | 0.75–1.94 |
| 60+ | 2.33 | 0.000 | 1.72–3.16 | 2.57 | 0.000 | 1.74–3.8 | 1.94 | 0.010 | 1.17–3.21 |
| Sex | |||||||||
| Male | |||||||||
| Female | 0.87 | 0.111 | 0.73–1.03 | 0.79 | 0.030 | 0.64–0.98 | 1.10 | 0.530 | 0.82–1.49 |
| Race | |||||||||
| White | Reference | ||||||||
| Black | 0.98 | 0.834 | 0.78–1.22 | 0.82 | 0.172 | 0.61–1.09 | 1.29 | 0.160 | 0.9–1.85 |
| Asian/Pacific Islander | 1.01 | 0.974 | 0.66–1.53 | 1.14 | 0.619 | 0.69–1.88 | 0.75 | 0.465 | 0.35–1.61 |
| Other/Unknown | 1.36 | 0.107 | 0.94–1.99 | 1.27 | 0.321 | 0.8–2.01 | 1.63 | 0.139 | 0.85–3.1 |
| Insurance Status | |||||||||
| Uninsured | 0.87 | 0.452 | 0.59–1.26 | 0.87 | 0.556 | 0.55–1.39 | 0.94 | 0.837 | 0.5–1.75 |
| Insured | Reference | ||||||||
| Medicaid | 0.69 | 0.001 | 0.55–0.85 | 0.61 | 0.000 | 0.47–0.8 | 0.85 | 0.38 | 0.59–1.22 |
| Medicare | 1.53 | 0.006 | 1.13–2.07 | 1.17 | 0.461 | 0.77–1.77 | 2.29 | 0.001 | 1.44–3.65 |
| Zipcode Income | |||||||||
| < $38,000 | Reference | ||||||||
| $38,000–$47,999 | 0.81 | 0.099 | 0.64–1.04 | 0.65 | 0.007 | 0.48–0.89 | 1.17 | 0.450 | 0.78–1.76 |
| $48,000–$62,999 | 0.77 | 0.032 | 0.6–0.98 | 0.87 | 0.342 | 0.65–1.16 | 0.62 | 0.033 | 0.4–0.96 |
| $63,000+ | 0.92 | 0.468 | 0.72–1.16 | 1.01 | 0.950 | 0.76–1.34 | 0.77 | 0.250 | 0.49–1.2 |
| Zipcode Education | |||||||||
| 21% or more | Reference | ||||||||
| 13–20.9% | 0.96 | 0.713 | 0.75–1.22 | 0.91 | 0.551 | 0.68–1.23 | 1.06 | 0.769 | 0.71–1.6 |
| 7–12.9% | 0.90 | 0.356 | 0.71–1.13 | 0.94 | 0.678 | 0.71–1.25 | 0.84 | 0.424 | 0.56–1.28 |
| < 7% | 0.98 | 0.851 | 0.76–1.25 | 1.11 | 0.484 | 0.82–1.5 | 0.73 | 0.176 | 0.46–1.15 |
| Urban | |||||||||
| Metro | 0.49 | 0.016 | 0.28–0.87 | 0.48 | 0.108 | 0.2–1.17 | 0.60 | 0.187 | 0.28–1.28 |
| Urban | 0.52 | 0.035 | 0.29–0.96 | 0.55 | 0.196 | 0.22–1.37 | 0.57 | 0.193 | 0.25–1.32 |
| Rural | Reference | ||||||||
| Distance from Hospital (Miles); mean (95% CI) | 1.00 | 0.547 | 1–1 | 1.00 | 0.536 | 1–1 | 1.00 | 0.982 | 1–1 |
| Year of Diagnosis | 1.00 | 0.771 | 0.98–1.03 | 0.99 | 0.585 | 0.96–1.03 | 1.04 | 0.083 | 0.99–1.1 |
| < 2006 | Reference | ||||||||
| 2006–2010 | 1.06 | 0.614 | 0.84–1.33 | 1.01 | 0.935 | 0.77–1.34 | 1.18 | 0.414 | 0.79–1.77 |
| 2011–2015 | 1.01 | 0.949 | 0.78–1.3 | 0.91 | 0.529 | 0.67–1.23 | 1.40 | 0.138 | 0.9–2.18 |
| Location | |||||||||
| Lower Limb | Reference | ||||||||
| Upper Limb | 1.52 | 0.000 | 1.23–1.89 | 1.38 | 0.013 | 1.07–1.78 | 2.24 | 0.000 | 1.51–3.33 |
| Long vs Short Bone | |||||||||
| Short Bone | Reference | ||||||||
| Long Bone | 3.89 | 0.000 | 2.44–6.19 | 2.25 | 0.007 | 1.24–4.06 | 6.68 | 0.000 | 3.2–13.95 |
| AJCC Clinical Stage | |||||||||
| Stage 1A or 1B | |||||||||
| Stage 2A or 2B | Reference | ||||||||
| Stage 3 | 1.34 | 0.195 | 0.86–2.07 | 1.70 | 0.045 | 1.01–2.87 | 0.79 | 0.573 | 0.35–1.79 |
| Stage 4A or 4B | 2.82 | 0.000 | 2.33–3.4 | 2.88 | 0.000 | 2.28–3.64 | 2.73 | 0.000 | 1.96–3.78 |
| Osteosarcoma Type | |||||||||
| Osteosarcoma NOS | |||||||||
| Chondroblastic | 0.90 | 0.324 | 0.74–1.11 | 1.07 | 0.573 | 0.84–1.37 | 0.65 | 0.023 | 0.45–0.94 |
| Fibroblastic | 0.63 | 0.067 | 0.39–1.03 | 0.46 | 0.024 | 0.24–0.9 | 1.15 | 0.708 | 0.56–2.34 |
| Telangiectatic | 0.95 | 0.775 | 0.65–1.38 | 0.96 | 0.870 | 0.61–1.51 | 0.99 | 0.974 | 0.48–2.03 |
| Central | 0.71 | 0.288 | 0.38–1.34 | 0.76 | 0.461 | 0.37–1.56 | 0.79 | 0.740 | 0.19–3.2 |
| Surface/Juxtacortical | |||||||||
| Tumor Size (cm); mean (95% CI) | 1.01 | 0.002 | 1–1.01 | 1.00 | 0.174 | 1–1.01 | 1.02 | 0.000 | 1.01–1.03 |
| < 8 cm | Reference | ||||||||
| > 8 cm | 1.68 | 0.000 | 1.38–2.04 | 1.44 | 0.002 | 1.15–1.81 | 2.27 | 0.000 | 1.53–3.39 |
| Presence of Metastases at Dx | |||||||||
| No metastases | Reference | ||||||||
| metastases | 2.93 | 0.000 | 2.44–3.53 | 3.00 | 0.000 | 2.39–3.76 | 2.79 | 0.000 | 2.02–3.86 |
| Comorbidities at Dx | |||||||||
| No comorbidities | Reference | ||||||||
| 1 or more | 1.02 | 0.916 | 0.77–1.34 | 0.86 | 0.429 | 0.6–1.24 | 1.30 | 0.247 | 0.83–2.01 |
| Received Adjuvant Chemotherapy | |||||||||
| No | Reference | ||||||||
| Yes | 0.58 | 0.001 | 0.42–0.79 | 0.80 | 0.326 | 0.51–1.25 | 0.38 | 0.000 | 0.24–0.59 |
| Surgical Margins | |||||||||
| Clear | Reference | ||||||||
| Positive | 2.86 | 0.000 | 2.11–3.88 | 3.36 | 0.000 | 2.41–4.69 | 1.85 | 0.116 | 0.86–3.99 |
| Unplanned Readmission After Surgery | |||||||||
| No Unplanned Readmiss | Reference | ||||||||
| Unplanned Readmission | 0.69 | 0.121 | 0.43–1.1 | 0.69 | 0.192 | 0.4–1.2 | 0.67 | 0.374 | 0.27–1.62 |
| Inpatient Days after Surgery; mean (95% CI) | 1.00 | 0.801 | 0.99–1.01 | 1.00 | 0.942 | 0.99–1.01 | 1.01 | 0.164 | 0.99–1.03 |
| Days from Dx to Surgery; mean (95% CI) | 1.00 | 0.602 | 1–1 | 1.00 | 0.144 | 1–1 | 1.00 | 0.321 | 1–1 |
| Days from Dx to Treatment Commencing; mean (95% CI) | 1.00 | 0.020 | 1–1.01 | 1.01 | 0.000 | 1–1.01 | 1.00 | 0.528 | 0.99–1 |