Poorer prognosis of African-American patients with mycosis fungoides: an analysis of the SEER dataset, 1988 to 2008

Abstract

Background: The aims of this study were: (1) to determine whether AA patients with MF have a worse prognosis despite accounting for varying clinical factors at presentation, and (2) to assess whether a racial disparity exists regarding utilization of radiation therapy (RT) as an initial treatment modality.

Materials and methods: The SEER 1988-2008 public use database was investigated. Univariate and multivariate analysis was used to assess for factors significantly associated with disease-specific survival (DSS), overall survival (OS), and RT utilization survival.

Results: A total of 4892 patients with MF were identified with a median follow-up of 58 months. On multivariate analysis including tumor registry, age, sex, marital status, and tumor stage, AA race was significantly correlated with a worse OS (hazard ratio [HR], 1.58; P < .001) and DSS (HR, 1.78; P < .001). With regard to RT utilization, more advanced age (odds ratio [OR], 1.005; P < .001) and higher stage (OR, 3.03; P < .001) were associated with a higher likelihood of receiving RT, whereas female sex (OR, 0.81; P = .03) was associated with a lower likelihood of receiving RT. AA race was not significantly associated with RT utilization (P = .58).

Conclusion: AA race was associated with poorer survival despite accounting for demographic factors and tumor stage. Differences in RT utilization according to AA race were not found, however RT was less utilized for female patients. The etiology of this poorer prognosis is unclear and might be related to access to medical care, socioeconomic factors, or undetermined biological differences.

Keywords: Cutaneous; Prognosis; Race; Radiation utilization; Survival.

Figure 1

Overall survival by race.