Financial Toxicity in Patients With Resected Localized Primary Sarcoma of the Extremities

BACKGROUND AND OBJECTIVES: Financial toxicity (FT) describes the financial burden of cancer treatment and survivorship. This topic has never been studied before in patients with localized sarcoma of the extremities. METHODS: Patients who underwent resection for localized extremity sarcoma between 2016 and 2024 were surveyed using the Comprehensive Score for Financial Toxicity (COST) questionnaire and an additional composite survey identifying risk factors and coping mechanisms for FT. Logistic regression models identified risk factors associated with FT. RESULTS: Two hundred and thirty-four patients were contacted and 74 (31.6%) responded. Twenty-eight patients (37.8%) experienced FT. Patients who experienced FT were younger (p = 0.011), had lower household income (p = 0.033), and had lower credit scores (p < 0.001). Univariable analysis demonstrated that Medicare coverage (OR = 0.17, p = 0.03) and stable work hours (OR = 0.08, p = 0.004) were protective against FT. Upon multivariable analysis, credit score below 740 (OR = 26.00, p < 0.001) and being unmarried (OR = 6.48, p = 0.018) were risk factors for FT. Coping mechanisms, such as decreased spending on necessities and leisure, using savings or borrowing money, and skipping clinic visits were more likely to be reported by patients experiencing FT (all p < 0.05). CONCLUSIONS: Patients undergoing resection for primary bone and soft tissue sarcoma of the extremities experienced high rates of FT with identifiable risk factors and coping mechanisms.