{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:34:42Z","timestamp":1789004082074,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"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":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Previous studies evaluating socioeconomic status (SES) in bone malignancies such as chondrosarcoma used the Cox Proportional Hazards model, which might overestimate risk compared to cause\u2010specific models like the Fine\u2010Gray model. This study aims to evaluate the prognostic significance of income status in chondrosarcoma using both models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with chondrosarcoma. Patients were stratified by SES indicators, including income levels (low: &lt;\u2009$55\u2009000, middle: $55\u2009000\u2013$70\u2009000, high: &gt;\u2009$70\u2009000) and rurality (urban vs. rural). Survival analysis was conducted using Cox Proportional Hazards and Fine\u2010Gray models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The inclusion criteria were met by 3678 patients with income distributions as follows: 72.5% high\u2010income, 18.3% middle\u2010income, and 9.2% low\u2010income. Cox analysis identified low\u2010income (hazard ratio [HR]\u2009=\u20091.43, 95%\u2010confidence interval [95%\u2010CI]: 1.10\u20131.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and rurality (HR\u2009=\u20090.71, 95%\u2010CI: 0.55\u20130.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) as significant prognostic survival factors. Fine\u2010Gray modeling attenuated the findings for low\u2010income (sub\u2010hazard ratio [SHR]\u2009=\u20091.36, 95%\u2010CI: 0.95\u20131.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.089) and rurality (SHR\u2009=\u20090.76, 95%\u2010CI: 0.54\u20131.07, <jats:italic>p<\/jats:italic>\u2009=\u20090.122).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SES influences chondrosarcoma survival, but its effect on cause\u2010specific mortality decreases when competing risks are considered. Fine\u2010gray modeling reveals critical nuances in survival analysis, stressing the need for appropriate statistical methods to interpret SES\u2010related disparities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.70031","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:25:32Z","timestamp":1752074732000},"page":"539-547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Income and Rurality Impact Overall Survival but not Cause\u2010Specific Survival in Patients With Chondrosarcoma: A Population\u2010Based Study From the SEER Database"],"prefix":"10.1002","volume":"132","author":[{"given":"Adrian J.","family":"Lin","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine at the University of California Los Angeles CA 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the University of California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumin","family":"Jeong","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at the University of California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fice","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Wessel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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 CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander B.","family":"Christ","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of California Los Angeles CA USA"},{"name":"Department of Orthopaedic Surgery Great Los Angeles VA Medical Center Los Angeles CA 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