Abstract
e23503 Background: Clear cell chondrosarcoma (CCCS) is an uncommon cancer and variant of chondrosarcoma affecting the proximal portion of long bones, commonly the femur or humerus. This low-grade and slowly progressing malignant tumor is often mistaken for benign tumors (i.e. chondroblastoma), but its histological features of benign giant cells and cells with clear cytoplasm alongside pathologic, roentgenographic, and clinical characteristics aid in its distinction. Accurate identification will guide the establishment of standard treatment algorithms and further improve treatment outcomes. CCCS has an overall 10-year survival rate of 89% with a median time to death from disease of 15.3 years. The National Cancer Database (NCDB) was analyzed to determine how patient demographic characteristics affect the diagnosis of CCCS. Methods: A retrospective cohort study from 2004 to 2020 was conducted using the NCDB. 188 patients were found with a histologically confirmed diagnosis of CCCS (ICD-9242-3). Gender, race, Hispanic origin, insurance coverage, type of treatment facility, and distance from patient residence to treatment facility were analyzed via descriptive statistics and trends in incidence were interpreted using regression analysis. Results: The frequency of patients diagnosed with CCCS has remained consistent since 2004 (R2 = 0.1) with over 11 diagnoses per year. Of the 188 patients found, the average age of diagnosis was 47.8 years (SD = 16.7, range = 14 – 90 years). Approximately two-thirds of patients were male (68.1%) and the remainder were female (31.9%). Most of the patients were White (84.6%). Patient Hispanic status could not be accurately determined due to limited data. More patients were in the top income quartile (31.9%) than those in the second (26.1%), third (19.7%), or fourth (12.2%) quartiles. The other 10.1% were of unknown income status. Most patients were privately insured (61.7%), followed by coverage under Medicare/Medicaid (27.1%). More patients lived in metropolitan counties with a population of 250,000 or more (85%) compared to less-populated urban or rural areas (15%). A large percentage of patients were treated at an academic/research program (61.6%) compared to non-academic programs (38.4%). Patients traveled an average of 65.8 miles (SD = 101.4, range = 0.8 – 793.0) to get to the treatment facility. Conclusions: CCCS remains a rare diagnosis. This study explores a significant gap in existing knowledge on patient characteristics that might present with CCCS. Most patients were White, insured by private insurance, in the top quartile of income earners, and lived in metropolitan areas. This novel study of socioeconomic factors in CCCS patients suggests that patients with higher socioeconomic status in highly-populated areas might have better access to this uncommon diagnosis. As such, additional research to comprehend the role that socioeconomic status might have on CCCS would be beneficial.