Patients with osteosarcoma and soft tissue sarcoma might become “cancer refugees” in some Japanese regional cities

Purpose “Rare cancer” is defined as malignancy with a disease prevalence (age-adjusted incidence rate) of less than six per 100,000 population. Proper treatments which these patients need cannot always be performed unless they find dedicated facilities. Patients tend to be desperate, searching for advice and care. Thus, they are called “cancer refugees”. Osteosarcoma and soft tissue sarcoma (OS/STS) are representative rare cancers in Japan. We conducted a retrospective analysis of patients with OS/STS to improve the current treatment modalities in a Japanese regional city. Patients and methods Twenty-one patients with OS/STS who were hospitalized to receive standard chemotherapy or palliative treatment were enrolled between October 2011 and January 2017. Patients with non-Hodgkin’s lymphoma (NHL) and advanced cancer who were treated in the palliative care unit (PCU) of the Kawasaki Medical School General Medical Center were recruited as the control groups. We analyzed the difference in residential area between patients with OS/STS and the control groups. Results Approximately one-third of patients with OS/STS were referred from hospitals outside of Okayama prefecture. The ratio of patients with OS/STS referred from Okayama city and/or the same medical administration area of Okayama prefecture was lower than that of patients with NHL and advanced cancer who were treated in the PCU. Conclusion Because the medical environment of patients with OS/STS in Japanese local cities has not been consolidated, completing medical care within the patient’s own medical administration area is difficult. Thus, some patients with OS/STS may become “cancer refugees” who are unable to receive standard therapy near their residence.

[1]  K. Yonemori,et al.  Systemic Therapy for Soft Tissue Sarcoma: Proposals for the Optimal Use of Pazopanib, Trabectedin, and Eribulin , 2017, Advances in Therapy.

[2]  A. Fedenko,et al.  A Meta-Analysis of Osteosarcoma Outcomes in the Modern Medical Era , 2012, Sarcoma.

[3]  G. Gatta,et al.  Rare cancers are not so rare: the rare cancer burden in Europe. , 2011, European journal of cancer.

[4]  S. Letzel,et al.  Preference for place of death in Germany. , 2011, Journal of palliative medicine.

[5]  L. Robbins,et al.  CEOs from Orthopaedic Centers Worldwide Meet to Discuss Common Challenges: 2010 Annual Meeting of the International Society of Orthopaedic Centers , 2011, HSS Journal ®.

[6]  H. Howe,et al.  The Occurrence of Rare Cancers in U.S. Adults, 1995–2004 , 2010, Public health reports.

[7]  Y. Robin,et al.  Frequency of Certain Established Risk Factors in Soft Tissue Sarcomas in Adults: A Prospective Descriptive Study of 658 Cases , 2008, Sarcoma.

[8]  J. Kane,et al.  The Treatment and Outcome of Patients With Soft Tissue Sarcomas and Synchronous Metastases , 2002, Sarcoma.

[9]  J. Fraumeni,et al.  Multiple primary cancers in families with Li-Fraumeni syndrome. , 1998, Journal of the National Cancer Institute.

[10]  B. Bui,et al.  Efficacy of lenograstim on hematologic tolerance to MAID chemotherapy in patients with advanced soft tissue sarcoma and consequences on treatment dose-intensity. , 1995, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.