Soft tissue and bone/joint sarcoma disaggregation in minorities.

Abstract

e23100 Background: Hispanic and APPI populations are usually aggregated in large databases when there can be a difference in prognostication and survival among the individual subgroups. This study aimed to evaluate those differences in patients with soft tissue sarcoma and bone/joint sarcoma. Methods: Using the National Cancer Database, we identified patients with stages I-IV soft tissue sarcomas (STS) and bone/joint sarcomas (BJS). Multivariable logistic regression estimated odds of advanced stage (III–IV) at diagnosis (AS). Multivariable Cox regression estimated 3-year overall survival (OS). Models were adjusted for age, comorbidity, insurance, diagnosis year, and income quartile, with Non-Hispanic White (NHW) as reference. Results: Among 22,486 STS patients (NHW 19,806; Hispanic 1,932; AAPI 748) Hispanic patients had higher AS (aOR 1.12, p = 0.040), while AAPI patients had similar AS (aOR 1.00, p = 0.957), compared to NHW. When disaggregated, Pacific Islander patients had higher AS (aOR 1.61, p = 0.048) and worse OS (aHR 1.63, p = 0.002), while South/Central American patients had better OS (aHR 0.72, p = 0.046). Indian/Pakistani (aHR 0.73, p = 0.063) and Korean patients (aHR 0.63, p = 0.075) showed borderline trends towards better OS. Among 11,821 BJS patients (NHW 10,160; Hispanic 1,335; AAPI 326) Hispanic patients had higher AS (aOR 1.23, p = 0.008) when compared to NHW. OS in Hispanic and AAPI patients was similar to NHW. When disaggregated, AS and OS did not significantly differ between Hispanic/AAPI and NHW patients. Conclusions: Odds of advanced stage at diagnosis and 3-year overall survival for STS and BJS were different between aggregated and disaggregated analyses of Hispanic and AAPI groups, highlighting the importance of disaggregation studies to uncover and address hidden subgroup specific disparities. Hispanic and AAPI disaggregated subgroups adjusted odds and hazards ratios compared to non-hispanic whites in soft tissue sarcoma. Subpopulation n aOR (95% CI) p aHR (95% CI) p Non-Hispanic White 19,806 Reference - Reference - Hispanic, Unspecified 1330 1.12 (0.99–1.27) 0.073 0.97 (0.88–1.07) 0.565 Mexican 344 1.14 (0.90–1.44) 0.273 0.93 (0.77–1.12) 0.430 South/ Central America 123 1.31 (0.90–1.92) 0.158 0.72 (0.52–0.99) 0.046 Puerto Rican 68 1.33 (0.76–2.37) 0.320 0.94 (0.62–1.45) 0.794 Dominican Republic 36 1.15 (0.60–2.28) 0.677 0.77 (0.45–1.33) 0.346 Cuban 31 0.86 (0.41–1.77) 0.672 0.69 (0.37–1.28) 0.237 Hawaiian 48 0.69 (0.36–1.31) 0.254 1.24 (0.78–1.96) 0.370 Indian/Pakistani 163 0.78 (0.56–1.10) 0.155 0.73 (0.52–1.02) 0.063 Filipino 138 0.85 (0.59–1.23) 0.391 1.01 (0.75–1.36) 0.945 Chinese 132 1.28 (0.88–1.86) 0.197 1.08 (0.81–1.44) 0.611 Korean 69 0.84 (0.50–1.39) 0.495 0.63 (0.38–1.05) 0.075 Vietnamese 62 0.89 (0.52–1.52) 0.674 0.80 (0.51–1.28) 0.354 Japanese 60 1.00 (0.58–1.75) 0.997 0.77 (0.50–1.20) 0.250