Exploring demographic and socioeconomic factors in eccrine adenocarcinoma: A National Cancer Database analysis.

Abstract

e18129 Background: Eccrine adenocarcinoma (EC) is a rare malignancy deriving from the eccrine glands. Current treatment options for EC include wide surgical excision, chemotherapy, and radiation therapy, but no previous studies have comprehensively outlined these methods. Despite surgery being the most common approach, the 10-year survival rate for metastatic EC remains only 9%. Analyzing the socioeconomic demographic factors of EC through the National Cancer Database (NCDB) can address gaps in our current understanding of EC and improve patient outcomes. Methods: This retrospective cohort study identified patients with a confirmed EC diagnosis (ICD-O-3 code 8413) within the 2004-2020 NCDB. Regression analysis and descriptive statistics were used to identify demographic factors associated with patients diagnosed with EC (age, sex, race, Hispanic ethnicity, education level, insurance coverage, type of treatment facility, distance to the facility, and Charleson-Deyo score). Results: The NCBD contained 895 patients with a confirmed diagnosis of EC between 2004 and 2020, demonstrating a stable incidence rate throughout this period (R^2 = 0.0). Non-Hispanic White individuals (94%) comprised the majority of the cohort, with most patients insured by Medicare (51%). The average age of diagnosis was 65.9 years (SD = 14.8, range = 12 - 90 years), and most resided in a large, metropolitan area (77.4%). A greater proportion of patients lived in higher-income areas (42%), compared to lower-income areas (15%). Patients were significantly more likely to receive treatment at an academic or research program treatment facility (46%) versus community cancer programs (5%), with most facilities located in the Atlantic region (39%). Surgery was the most common treatment modality (97%), with the most frequent procedures being wide excision of the tumor (25%), excisional biopsy (17%), and Mohs surgery (10%). The majority of patients who underwent a surgical operation had no residual tumor (81%), while a notable proportion (11%) had positive margins. Conclusions: To the best of our knowledge, this is the first NCDB analysis of socioeconomic and demographic factors of EC patients, filling a significant knowledge gap in the existing literature. The patients with EC are generally older and more frequently treated with wide excision. Notably, most patients with EC were non-Hispanic White individuals, Medicare-insured, residing in large metropolitan, higher-income areas. These patients were predominantly treated at academic or research facilities in the Atlantic region. Further investigation is necessary to better understand the role of demographic and socioeconomic factors in the diagnosis, treatment approaches, and overall survival of EC patients.