A Retrospective Audit of Treatment Non-Compliance among Osteosarcoma Patients from a Developing Country

Abstract

Abstract: Background: The study aims to assess the non-compliance rate along with the factors affecting the non-compliance among osteosarcoma patients presenting in our institution. Materials and Methods: Osteosarcoma patients who were treated at our institution between January 2014 to December 2020 were included in this study. Records were searched from Departmental Cancer Registry for details regarding treatment plans and follow-ups. The data of outcomes were compared with the standard guidelines. Patients who did not attend follow-ups, surgery or chemotherapy were termed as non-compliant. The patients or their next of kins were inquired about the factors behind non-compliance. Results: The study sample included 46 participants where 34 (74.9%) and 12 (26.1%) were male and females, respectively with a mean age of 19.7± 9.7 years. 11 (23.91%) participants were compliant with the prescribed treatment plans that included surgery, neoadjuvant, and adjuvant treatments whereas 35 (76.1%) of the participants were non-compliant either with surgery or chemotherapy. Amongst all included participants, the neoadjuvant chemotherapy plan was followed by 18 (39.13%) and adjuvant chemotherapy was followed by 10 (21.74%) candidates. Surgery was performed in 22 (44.9%). The patients who did not received chemotherapy was attributed to affordability (P=0.008) and patients’ or next to kins’ choices (P=0.02) while age (P=0.039), patients’ consent not given (78.3%; P=0.05), and stage II (52.2%; P=0.048) were predictors of surgical non-compliance. Conclusion: We conclude that the care deferred significantly from the guidelines regarding surgery and chemotherapy. Age, affordability, late stage, and personal choices are the significant predictors for non-compliance for chemotherapy and surgery.