Demographic, socioeconomic, and treatment patterns in malignant Brenner tumors: A National Cancer Database analysis.

Abstract

e17546 Background: Malignant Brenner tumor (MBT) is a rare and aggressive subtype of ovarian cancer, accounting for less than 1-2% of all ovarian malignancies. Despite its rarity, MBT carries a high mortality rate, with nearly 51% of patients succumbing to the disease within 5 years of diagnosis if the disease spreads from the ovaries. Surgical resection is the primary treatment, often combined with adjuvant therapies such as chemotherapy or radiation, though the optimal treatment strategy remains unclear. This study leverages the National Cancer Database (NCBD) to explore the demographic and socioeconomic factors associated with MBT, addressing a significant gap in the literature. Methods: A retrospective cohort analysis was conducted using the NCDB (2004–2020), including 476 patients with histologically confirmed MBT (ICD-O-3 code 9000/3). Demographic, clinical, and treatment variables were analyzed using descriptive statistics and regression models. Results: The study included 476 patients, with a mean age of 65.6 years (SD=12.8, range = 31-90 years). Most patients were female (99.8%) and non-Hispanic White (83.2%). Most patients were treated at academic/research programs (38.2%) or comprehensive community cancer programs (37.4%), with the highest proportion of facilities being located in the South Atlantic region (22.2%). Treatment patterns revealed that 97.9% of patients underwent surgical intervention, with the most common procedure being surgical removal of the primary site (30.7%). Adjuvant chemotherapy was administered to 42.2% of patients, while primary radiation therapy was used in 4.2% of cases. Palliative care was rarely utilized, with only 0.4% of patients receiving it. Most tumors were classified as Stage I (60.5%). The 5 year survival rate for localized disease was 94.5% and 51.3% in patients with extra-ovarian spread. The Charlson-Deyo comorbidity score was 0 for 69.3% of patients, indicating a low comorbidity burden. Medicare covered 53.2% of patients, while 33.8% were covered by private insurance. The median income for patients was distributed across quartiles, with 28.3% in the highest income bracket ($74,063 or more). Conclusions: This study represents the largest NCDB analysis of MBTs, providing critical insight into this rare ovarian cancer subtype. Most patients were non-Hispanic White, privately insured, and treated at academic/research programs. These results underscore the importance of early diagnosis and tailored treatment strategies for MBT patients.