{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:14:07Z","timestamp":1785795247559,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2005,3,28]],"date-time":"2005-03-28T00:00:00Z","timestamp":1111968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2005,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Young adults with cancer in the U.S. have had less improvement in survival than either younger patients or older patients. The authors attempted to determine whether similar deficits have occurred in young adults with sarcomas and, if so, then why.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In 38,144 young adults with sarcoma who were diagnosed during 1975\u20131998 and were followed by the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results Program, the average annual percent change in 5\u2010year survival was derived as a function of patient age. National sarcoma treatment trial data were obtained on 3242 patients who were entered onto NCI\u2010sponsored trials during 1997\u20132002.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>1) For patients with bone and soft\u2010tissue sarcomas, except Kaposi sarcoma (KS), the least survival improvement occurred between age 15 years and age 45 years. For patients with KS, the pattern was reversed, with the greatest survival increase occurring among patients ages 30\u201344 years. 2) The lowest participation rate in NCI\u2010sponsored sarcoma treatment trials occurred in patients ages 20\u201344 years. For patients with KS, the highest accrual rate occurred in patients ages 35\u201344 years. 3) The age\u2010dependent survival improvement and clinical\u2010trial accrual patterns were correlated directly (soft\u2010tissue sarcomas, <jats:italic>P<\/jats:italic> &lt; 0.005; bone sarcomas, <jats:italic>P<\/jats:italic> &lt; 0.05; KS, <jats:italic>P<\/jats:italic> = 0.06), regardless of whether the accrual profile demonstrated a decline or a peak (KS) during early adulthood.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The lack of survival prolongation in patients age 15\u201344 years in the U.S. with non\u2010KS sarcomas may have been a result of their relative lack of participation in clinical trials. If this is true, then reversing the shortfall in survival among young adults with sarcomas, as was accomplished among patients with KS, should benefit from increased clinical trial availability, access, and participation. Cancer 2005. Published 2005 by the American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20995","type":"journal-article","created":{"date-parts":[[2005,3,28]],"date-time":"2005-03-28T15:17:43Z","timestamp":1112023063000},"page":"1891-1897","source":"Crossref","is-referenced-by-count":159,"title":["National survival trends of young adults with sarcoma"],"prefix":"10.1002","volume":"103","author":[{"given":"Archie","family":"Bleyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Montello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Budd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Saxman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,4,18]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"389a","article-title":"United States cancer incidence, mortality and survival: young adults are lagging further behind","volume":"21","author":"Bleyer A","year":"2002","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.1257"},{"key":"e_1_2_6_4_2","volume-title":"U.S. cancer incidence, mortality and survival: young adults are lagging further behind","author":"Bleyer A","year":"2002"},{"key":"e_1_2_6_5_2","first-page":"586","article-title":"Young adults with leukemia in the United States: Lack of clinical trial participation and mortality reduction during the last decade","volume":"23","author":"Bleyer A","year":"2004","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_6_2","article-title":"Older adolescents and young adults with brain tumors in the United States: lack of clinical trial participation and of survival prolongation and mortality reduction","volume":"52","author":"Bleyer A","year":"2004","journal-title":"Proc Intl Symp Pediatr Neurooncol."},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2004.tb05799.x"},{"key":"e_1_2_6_8_2","first-page":"816","article-title":"Young Adults with sarcoma: lack of clinical trial participation and lack of survival prolongation","volume":"22","author":"Bleyer A","year":"2003","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_9_2","volume-title":"SEER cancer statistics review, 1975\u20132000","author":"Ries LAG","year":"2003"},{"key":"e_1_2_6_10_2","first-page":"2414","volume-title":"Holland\u2010Frei: cancer medicine","author":"Bleyer A","year":"2003"},{"key":"e_1_2_6_11_2","volume-title":"Analysis of the March 2000 current population survey of nonelderly (under 65)","author":"General Accounting Office","year":"2000"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(02)00035-4"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(05)70540-X"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10240"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199907000-00022"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.02.026"},{"key":"e_1_2_6_17_2","first-page":"816","article-title":"Cure rates in Ewing tumor patients aged over 15 years are better in pediatric oncology units. 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