Income level as a prognostic factor in non-dedifferentiated liposarcoma.

Abstract

e23558 Background: Liposarcoma is the most common soft tissue sarcoma and primarily arises in subcutaneous fat of the lower extremities. Previous research has shown socioeconomic factors (eg. Income, insurance status, facility type) to be strongly associated with patterns of care as well as overall survival in bone and soft tissue sarcoma patients. Using the NCDB, this study analyzed the association between income and survival in patients with non-dedifferentiated liposarcoma. Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with Liposarcoma from 2004 to 2019 using the histology codes 8850, 8851, 8852, 8853, 8855, and 8857 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Cox Proportional Hazards tests were performed. Data was analyzed using SPSS version 27 and statistical significance was set at α = 0.05. Results: Of 4631 patients included in the sample, 1508 (32.5%) were from the highest income ( > $46,000) bracket. High-income patients experienced longer mean overall survival (149 months) compared to middle (136.5 months) and low (130 months) income patients (p < 0.001). After controlling for age, tumor size, stage, and surgery of primary site, low-income patients experienced higher hazard ratios relative to the middle- and high-income groups (HR1.56; p < 0.001). On presentation, higher income patients had less co-morbidities, and tumors which were less aggressive (grade) and advanced (NCDB stage & metastasis) (p < 0.001). Furthermore, they were more likely to undergo surgery (90.3%) and had the shortest interval between diagnosis and definitive surgical procedure (p < 0.001). No differences were seen in surgical margins, palliative care, tumor size, or radiation dose. Conclusions: This study found that high-income patients with non-dedifferentiated liposarcoma experience improved overall survival and expedited surgery compared to middle- and low-income groups. Further research could elucidate the true cause of this disparity.