Clinical features and outcomes of patients with synchronous cancers in West Virginia.

Abstract

e23287 Background: Synchronous cancers, defined as ≥2 separate malignancies diagnosed in the same individual within 6 months, pose unique clinical challenges including almost universal exclusion from clinical trials. The prevalence of synchronous cancers has increased, ranging from 2% to 17%. The biology and risk factors for these cancers is not well understood and there is a paucity of data on clinical features and outcomes for these patients. Methods: We retrospectively reviewed charts of patients diagnosed with synchronous cancers at the West Virginia University Cancer Institute between 2020 and 2023. Demographic, geographic, and clinical data were collected. Patient geographic data was geocoded and mapped to federally designated Rural-Urban Commuting Area (RUCA) codes, which range from 1 (urban) to 10 (rural). Kaplan-Meier (log-rank) analysis was performed to investigate differences in 1-year progression-free survival (PFS) and overall survival (OS). Results: There were 285 patients in our analysis with a median age of 66 years (range, 24-98). Most patients had same-system diagnoses with the most common being breast (20.7%), skin (9.1%), lung (8.8%), thyroid (7.4%), and gastrointestinal (GI) (5.6%). The median OS and median PFS were not reached in the current follow-up period. There were significant differences in 1-year PFS (0.42 vs 0.58, P = 0.001) and 1-year OS (0.63 vs 0.79, P < 0.005) between males and females, respectively, and between diagnosis groups (1-year PFS, P < 0.001 and 1-year OS, P = 0.004), with improved survival in breast, thyroid, and skin synchronous cancer patients. Conclusions: To our knowledge, this is the first and largest analysis of rural synchronous cancer patients. Notable survival disparities were observed between males and females and different diagnosis groups. These data are particularly valuable for risk factor assessment in a patient population that is underrepresented in the literature and highlights the need for continuing research.