Abstract 60: Low-Income is a Negative Prognostic Factor in Patients With MPNST: An NCDB Analysis

Abstract

Abstract Purpose: Malignant Peripheral Nerve Sheath Tumors (MPNST) are a form of soft tissue tumor that forms from the Schwann cell lineage. Previous studies have noted that treatment at income is generally associated with improved survival in cancer patients. Thus, the objective of this study was to investigate the influence of patient income level on overall survival for patients with MPNST. Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with MPNST from 2004 to 2019 using the ICD-O-3 histology code 9540. Median Income Quartiles were identified as assigned by the Commission on Cancer Accreditation program and re-classified into three categorical variables: high (HI= >$46,000) middle (MI =$30,000 – $45,999) and low (LI =<$29,000). Descriptive statistics and Kaplan Meier curves were used to measure survival in these patients and Chi-square analyses were used to evaluate differences in demographics. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: Of the 2222 patients with MPNST queried, 2,023 met selection criteria for Kaplan-Meier analysis. Patients in the high-income bracket experienced the longest median survival (83.6 months) compared to 47 and 37 months for the median- and low-income groups, respectively. A Log-Rank test found the difference in survival by income groups to be statistically significant. A Cox Proportional Hazards Model revealed that increased income was not significantly associated with decreased hazard (death), however being in the lowest income bracket was associated with a 41% increase in the relative risk of death (HR 1.41; 95% CI 1.19-1.67). Low-income patients did not present with more advanced disease, however, they experienced a longer average delay in the onset of treatment and were significantly more likely to be uninsured and of Black or Native American) race. Conclusion: This retrospective cohort study found that for patients with MPNST, low income was independently associated with inferior survival. These patients were more likely to be a minority race and presented with less insurance coverage. They thus experienced a longer duration between diagnosis and the initiation of therapy compared to patients with higher incomes. Citation Format: Jared Kennard, Marco Braaten, Peter Silberstein. Low-Income is a Negative Prognostic Factor in Patients With MPNST: An NCDB Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 60.