Racial disparities in tenosynovial giant cell tumor: An analysis of the Surveillance, Epidemiology and End Results database.

Abstract

e23517 Background: Tenosynovial Giant Cell tumor (TGCT) is a rare disease classified either as localized (L-TGCT) or as diffuse type (D-TGCT). Epidemiologic studies often report incidence, prevalence, and gender distribution, but no study has ever explored the racial distribution of TGCT. Two phase III randomized trials (MOTION and ENLIVEN) exploring the use of CSF-1R inhibitors in TGCT reported an overwhelming majority of patients belonging to the white race. In this analysis of the Surveillance, Epidemiology, and End Results (SEER) database, we explored the hypothesis of whether TGCT predominantly affects the white race or not. Methods: We analyzed the SEER 8 and SEER 22 databases. The population of interest consisted of cases diagnosed with TGCT, identified by the ICD-O-3 codes 9252/0 (Benign TGCT) and 9252/3 (Malignant TGCT). The primary variables studied were demographic characteristics, including race, sex, and age at diagnosis. Chi-square tests were conducted to evaluate the statistical significance of the distribution of TGCT cases across racial, sex, and age groups. Survival analyses used overall and relative survival with their respective standard errors. All statistical analyses were conducted using SPSS (version X). A p-value of < 0.05 was considered statistically significant in assessing the differences among the demographic groups. Results: In the SEER 22 database, 78 patients were identified with TGCT, out of whom 61 patients had full details. Fifty-one patients were White, 5 patients were Black, and 5 were Asian or pacific islander (AoPI) (χ 2 = 31.75, P < 0.001, Confidence Interval (CI): 0.547,0.761). Thirty-one patients were men, and 30 were women (χ 2 = 0.16, P-0.89, CI: 0.39,0.62). In the SEER 8 database, 22 patients were identified with TGCT, out of whom 19 were white, 2 were black, and 1 was AoPI (χ 2 = 20.86, P < 0.001, CI: 0.67,0.97). Ten patients were men, and 12 were women, with no statistical difference in age. In both datasets, TGCT had a higher prevalence in middle-aged patients. Survival analysis was done with the SEER 22 dataset. No statistical difference was noted in the overall survival at 12 months (98.5%, 80%, and 87.6% for white, black, and AoPI, respectively) and 60 months (87.9%, 80%, and 87.6% for white, black, and AoPI respectively). Conclusions: TGCT afflicts the white race in significantly higher numbers compared to blacks, Hispanics, and AoPI. There are no significant differences in gender distribution or survival amongst different races. The predominance of TGCT in the white race has implications for drug development in such patients where intense scrutiny of pharmacokinetic data is required in the non-white races to ascertain the true impact of these drugs.