{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T15:16:35Z","timestamp":1774106195442,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Soft tissue sarcomas (STSs) are rare but can be devastating. Paradigm shifts in adjuvant treatment have expanded the availability of limb salvage; however, a subset of patients still require amputation. The aim of this study was to examine the impact of patient, disease, and practice\u2010related factors on rates of amputation in STS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All adults undergoing resection for STS of the extremities were tabulated from the 2004\u20132021 National Cancer Database (NCDB). Multivariable models were utilized to evaluate risk factors for undergoing amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 31\u2009805 patients, 1880 (6%) underwent amputation. Those who underwent amputation were younger (57 vs. 60, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001), more commonly Black (12% vs. 9%, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.00), and more frequently Medicaid insured (11% vs. 6%, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001). Amputation patients experienced a longer time from diagnosis to surgery, compared to limb salvage patients (46 [23\u201391] vs. 37 days [9\u201393], <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001). Amputation was associated with a significantly greater hazard of overall mortality over 10\u2009years following resection (HR 1.66, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report significant race\u2010, income\u2010, and insurance\u2010based disparities in amputation risk and overall survival for patients with STS of the extremities. We also report a significantly increased risk of amputation for patients with delayed clinical presentation. Multidisciplinary sarcoma care teams should be aware of these disparities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.28077","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:34:47Z","timestamp":1736404487000},"page":"1431-1438","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Income and Insurance\u2010Based Disparities in Primary Soft Tissue Sarcoma of the Extremities"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-9484","authenticated-orcid":false,"given":"Charlotte F.","family":"Wahle","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Sakowitz","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB) University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole J.","family":"Newman\u2010Hung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3338-5878","authenticated-orcid":false,"given":"Nicholas M.","family":"Bernthal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peyman","family":"Benharash","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB) University of California Los Angeles California USA"},{"name":"Department of Surgery University of California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren 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