Racial disparity in mycosis fungoides: An analysis of 4495 cases from the US National Cancer Database

Abstract

Background: Studies have shown contradictory results regarding the survival outcomes among white, African American, and Asian patients with mycosis fungoides (MF).

Objective: To evaluate the survival outcomes among white, African American, and Asian patients with MF and to determine other prognostic factors of the disease.

Methods: The US National Cancer Database was used to identify patients with histologically confirmed MF from 2004 to 2014. Clinicopathologic, socioeconomic, and treatment data were compared among the races by using the chi-square test. Overall survival was evaluated by using the log-rank test, multivariable Cox proportional hazard regression, and propensity score-matched analysis.

Results: Of 4459 patients with MF, 77.7% were white, 19.2% were African American, and 3.2% were Asian. Older age, treatment received in a community facility, government insurance, higher Charlson-Deyo score, male sex, higher clinical stage, receipt of radiotherapy or chemotherapy, and African American race were predictors of poor overall survival on multivariate analysis (P < .001), whereas Asian race trended toward improved outcomes (P = .07).

Limitations: Retrospective analysis.

Conclusion: African American patients with MF demonstrated poorer survival than white patients after accounting for disease characteristics, socioeconomic factors, and types of treatment, warranting further investigation into the underlying biology of MF and prescribed treatment modalities.

Keywords: cutaneous T-cell lymphoma; mycosis fungoides; prognosis; race; socioeconomic factors.