Ceruminous adenocarcinoma: A National Cancer Database study of demographic characteristics.

Abstract

e18084 Background: Ceruminous adenocarcinoma (CA) is a rare form of malignancy that originates from the ceruminous glands located in the external auditory canal. Despite its rarity, 25% of CA patients succumb to the disease within two years of diagnosis. Radiation treatment improves the 10-year survival rate to 60%, up from 30% without radiation treatment. Due to the rarity of CA, the diagnostic trend of the disease could offer valuable insight into its epidemiology. The National Cancer Database (NCDB) database was analyzed to determine the demographic factors in patients diagnosed with CA. Methods: A retrospective cohort analysis utilizing the 2004–2020 National Cancer Database (NCDB) included patients with a histologically-confirmed diagnosis of CA (N = 37). Demographic factors (age, sex, race, Hispanic status, educational attainment, insurance status, facility type, distance from facility, and Charles/Deyo score) were analyzed by descriptive statistics and incidence trends were interpreted in regression analysis. Results: A total of 37 patients were identified in the database with a confirmed diagnosis of CA between 2004 – 2020 with a steady incidence of patients diagnosed per year (R2 = 0.0). The average age of diagnosis was 59.7 years (SD = 16.5, range = 14 – 90 years). The top primary site was the external ear (89.2%), although primary sites on other areas of the skin did occur. Most individuals (89.2%) had Charlson/Deyo comorbidity scores of 0. The majority of the patients were Non-Hispanic White (89.1%). More patients were in the top quartile of income earners (35.5.%) compared to those in the second, third, or fourth quartiles. A higher percentage of patients were privately insured (51.4%) than those who were uninsured or insured by Medicare/Medicaid. More patients lived in metropolitan counties with a population greater than 1 million (43.2%) than in other metropolitan counties (35.1%). Fewer patients were treated in an academic/research program (40.5%) than in a non-academic program (46.0%). Patients lived an average of 43.3 miles (SD = 74.7, range = 1.8 – 370) from the treatment facility. No patients received palliative care. Conclusions: This is the first NCDB analysis on CA to the best of our knowledge and thus addresses a significant knowledge gap on the topic. The majority of CA patients tend to be non-Hispanic and White with a primary site diagnosis presenting at the external ear, similar to earlier descriptions in case reports. This is the first time the socioeconomic factors of CA patients have been described in the literature: CA patients are more likely to be in the top income quartile, live in densely-populated metropolitan areas, and be treated in a non-academic program. Further research is needed to better understand the impact of demographic and socioeconomic factors on the diagnosis of, treatments utilized against, and overall survival of patients with CA.