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. 2022 Sep 2;31(9):1830-1838.
doi: 10.1158/1055-9965.EPI-21-0997.

The Role of Socioeconomic Status and Race/Ethnicity in Malignant Peripheral Nerve Sheath Tumor Survival: A Surveillance, Epidemiology, and End Results-Based Analysis

Allison M Domingues  1 , Christopher L Moertel  2   3   4 , Erin L Marcotte  1   2   3
Affiliations

The Role of Socioeconomic Status and Race/Ethnicity in Malignant Peripheral Nerve Sheath Tumor Survival: A Surveillance, Epidemiology, and End Results-Based Analysis

Allison M Domingues et al. Cancer Epidemiol Biomarkers Prev. .

Abstract

Background: Recent investigations of malignant peripheral nerve sheath tumor (MPNST) survival have reported higher mortality among non-White individuals. However, previous analyses have not examined the impact of socioeconomic status (SES) on these observations. This study aims to characterize factors associated with cause-specific MPNST survival, including information related to census-tract-level SES (CT-SES).

Methods: We identified 2,432 primary MPNSTs using the Surveillance, Epidemiology, and End Results (SEER) 18 (2000-2016) database. We used Cox proportional hazards modeling to estimate the effects of sex, race/ethnicity, CT-SES quintile, metastasis at diagnosis, tumor site, age at diagnosis, and treatment by surgery on survival. Models were fit in both the full population and, separately, stratified by race/ethnicity and age at diagnosis (<40 vs. ≥40).

Results: In adjusted models, age at diagnosis, CT-SES, and metastasis at diagnosis were associated with mortality. In race/ethnicity-stratified analysis, higher CT-SES was found to improve survival only in the White population. Among those diagnosed before age 40, metastasis at diagnosis and American Indian/Alaska Native race/ethnicity were associated with mortality, and both Hispanic ethnicity and Asian/Pacific Islander race were suggestive for increased mortality. Among cases, diagnoses at age 40 and above, age at diagnosis, male sex, and CT-SES were associated with mortality.

Conclusions: This analysis provides evidence that among pediatric and young adult patients, non-White populations experience inferior survival compared with Whites, independent of CT-SES. Our findings also suggest that the effect of CT-SES on MPNST survival may differ by racial/ethnic group.

Impact: These findings suggest that barriers to healthcare for certain racial/ethnic groups extend beyond SES.

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Conflict of interest statement

Disclosures: Authors declare no potential conflicts of interests.

Figures

Figure 1.
Figure 1.. Kaplan-Meier survival by race/ethnicity.
Kaplan-Meier survival curves for individuals diagnosed with MPNSTs between 2000 and 2016, stratified by racial/ethnic group. Number at risk by category at select time points is additionally displayed below. Abbreviations: AI/AN=American Indian/Alaska Native, API=Asian/Pacific Islander
Figure 2.
Figure 2.. Kaplan-Meier survival by Yost quintile.
Kaplan-Meier survival curves for individuals diagnosed with MPNSTs between 2000 and 2016, stratified by Yost quintile. Number at risk by category at select time points is additionally displayed below. Abbreviations: Q1=Quintile 1, Q2=Quintile 2, Q3=Quintile 3, Q4=Quintile 4, Q5=Quintile 5
See this image and copyright information in PMC

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