Adenocarcinoma with cartilaginous and osseous metaplasia: A study of demographic and socioeconomic factors using the NCDB.

Abstract

e12687 Background: Adenocarcinoma with cartilaginous and osseous metaplasia (ACOM) is a rare malignant tumor where gland-forming cells undergo abnormal transformation into cartilage and bone. Complete surgical removal and chemotherapy are the strongest predictors of lower recurrence and longer overall survival; however, on account of the infrequency of this disease, demographic and socioeconomic data remain scarce. In this cohort study, the National Cancer Database (NCDB) was used to further characterize the demographic and socioeconomic factors in these patients. Methods: A retrospective cohort study utilizing the 2004-2020 National Cancer Database encompassed 212 patients with a confirmed diagnosis of ACOM ICD-O-3 code (8571). Factors including age, sex, race, Hispanic status, highest level of education, insurance coverage, facility type, distance traveled for treatment, and Charleson-Deyo score were evaluated using descriptive statistics. Incidence trends were analyzed using regression modeling. Results: This cancer disproportionately affected women (98.1%). The most common primary site was the upper quadrant of the breast (37.7%). The majority of this cohort were Non-Hispanic (87.7%), were White (74.5%), and lived in metropolitan areas (58.5%). Most patients presented with stage II (39.2%) and stage I (32.1%) disease. Comorbidity burden was low, with a majority of individuals (76.4%) having a Charlson-Deyo score of 0. Nearly half of the patients were privately insured (48.6%). Most individuals were treated using chemotherapy (75.5%) and radiation therapy (51.9%), while few received treatment through hormone therapy (3.8%) and immunotherapy (2.8%). Long-term survival at two, five, and ten years was 90%, 80%, and 70% respectively. Conclusions: To our knowledge, this represents the first NCDB analysis examining ACOM, thereby addressing a gap in literature. Aligning with prior published reports, ACOM mostly affected Non-Hispanic and White patients with tumors found mainly in the upper quadrant of the breast. This study represents the first characterization of socioeconomic factors among ACOM, with the majority of patients living in the metropolitan areas. Further work is needed to clarify how the demographic and socioeconomic characteristics of ACOM affect diagnosis, treatment modalities, and patient survival.