Impact of race, gender and socioeconomic status on Ewing sarcoma survival over two decades.

Abstract

e23514 Background: Ewing’s Sarcoma is a rare malignant tumor of the bone or soft tissue often afflicting children and young adults. While several studies have analyzed and defined the clinicopathological variables that impact prognosis and survival in Ewing’s Sarcoma, the sociodemographic aspects of the disease remain elusive. The aim of this study is to assess the influence of various epidemiological characteristics on survival outcomes for Ewing’s Sarcoma via a database-driven approach. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Database, a cohort of Ewing’s Sarcoma patients with a diagnosis occurring between 2000-2021 was extracted via ICD-0-3 coding. Information on gender, race, income, and residence was collected with cause-specific survival serving as the primary outcome. The Kaplan-Meier method was utilized to estimate 5-year overall survival rates (OS) and Hazard ratios (HR) were employed to compare the OS between groups. Finally, the Cox Proportional Hazards Regression was used to conduct a multivariate modelling of survival and the difference between the observed number of events in each group was compared via a log-rank statistical test. Results: In total, epidemiological information on a cohort of 1,793 Ewing’s Sarcoma patients was gathered. In terms of gender, the M/F ratio was found to be 1.1. Caucasians made up the largest proportion of the cohort (58.3%), followed by Hispanics (25.9%), Non-Hispanic Asian/Pacific Islanders (8.4%), African Americans (6.4%), and Alaskan Natives/Native Americans (1.1%). The majority of patients reported a household income of greater than $70,000 (70.9%) and most lived in an urban area (83.0%). Compared to females, males had a significantly worse 5-year OS, with an HR of 1.2 (95% CI: 1.05-1.2, p=0.016). With regards to race, using African American OS as a reference, both Hispanics, with a HR of 0.72 (95% CI: 0.54-0.98, p=0.021), and Caucasians, with a HR of 0.70 (95% CI: 0.54-0.91, p<0.01), had better 5-year OS. No significant differences in 5-year OS of Ewing’s Sarcoma were found based on income or residence. Conclusions: This study suggests that demographic factors, including gender and ethnicity may impact prognosis and survival in Ewing’s Sarcoma. It highlights the importance of not only considering clinical parameters of Ewing’s Sarcoma but also taking into account sociodemographic characteristics in the treatment and management of the disease. Sociodemographic factors impacting survival outcomes in Ewing’s sarcoma. Characteristic Groups HR (95% CI) P-value Sex FemaleMale -1.2 (1.05-1.4) 0.016* Race African AmericanHispanicNHAPINHAIANCaucasian -0.72 (0.54-0.95)0.80 (0.57-1.11)0.55 (0.25-1.21)0.70 (0.54-0.91) 0.0210.1860.1370.007* Household Income >$70,000<$70,000 -0.94 (0.81-1.1) 0.426 Residence Urban Rural 0.96 (0.81-1.2) 0.681