Dr Randall on the Importance of Addressing Socioeconomic Disparities to Improve Sarcoma Survivorship

"If the social services around a patient determine that [they have] some disadvantaged socioeconomic situations, we want to really make sure that they get into a formal survivorship clinic."

R. Lor Randall, MD, FACS, the David Linn Endowed Chair for Orthopedic Surgery, chair of the Department of Orthopedic Surgery, and a professor at UC Davis Comprehensive Cancer Center, spotlighted the potential implications of key prospective research on disparities in survivorship care in pediatric sarcoma, which is being conducted by his colleague Elysia Marie Alvarez, MD, MPH.

Findings from a prior study on guideline-concordant care, which was also spearheaded by Alvarez and has been published in Lancet Oncology, patients facing worse socioeconomic circumstances—such as those with lower resources, lower insurance levels, or facing more socioeconomic disparity—survive their cancers similarly to well-resourced patients, but they frequently go on to face many more lifelong complications. Randall noted that for both pediatric and medical oncologists, once treatment is complete, if patients have disadvantaged socioeconomic situations, they should be strongly directed toward a formal survivorship clinic, as many oncologists fail to prioritize survivorship over immediate survival.

Alvarez's efforts to establish standards for sarcoma survivorship outcomes related to guideline-concordant care for pediatric bone tumors is expected to reframe survivorship as a continuation of cancer biology admixed with socioeconomic variables, Randall asserted. This approach moves beyond historical assessments that focused only on socioeconomic and cultural variables, Randall stated. The ultimate goal is to enable investigators to predict precisely which patients will need additional interventions during their survival, establishing a persistent survivorship platform where high-risk patients receive targeted, specialized long-term care, he concluded.