Survival by race among children with extracranial solid malignancies.

Abstract

9559 Background: Previous studies of outcome by race in the pediatric oncology literature have focused in large part on children with leukemia and lymphoma. Data regarding outcomes by race for children diagnosed with extracranial sold tumors are limited, and little has been published regarding outcomes of patients from racial groups other than white or black. Methods: The National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database was used to compare survival rates by race among patients diagnosed with common extracranial solid malignancies of childhood between 1985 and 2005. Survival trends for children diagnosed with eight common extracranial malignant solid tumors were evaluated using SEER 17 data. Five-year survival probabilities were calculated using the Kaplan-Meier method. Survival hazard ratios were calculated using a Cox proportional hazards model, and were compared for patients identified in SEER as white, black, and American Indian/Alaskan Native and Asians/Pacific Islander. Results: Five-year survival probabilities were higher for white children than for children belonging to either minority group (77% vs 72%, P < 0.05). The 5-year survival rate for male non-white children was lower than that of male white children (67% for black males and 68% for American Indian/Alaska Native + Asian/Pacific Islander males vs 77% for white males), while there were no differences in survival among females across racial groups. Compared to white children, black children had a higher risk of death overall (1.25, P < 0.05) and a higher risk of death from hepatoblastoma and non-rhabdomyosarcoma soft tissue sarcomas. American Indian/Alaskan Native and Asian/Pacific Islander children also had a higher risk of death overall (1.32, P < 0.05) and higher risks of death from germ cell tumors, hepatocellular carcinoma, neuroblastoma and Wilms tumor when compared to white children. Conclusions: Male children from minority groups have poorer survival from extracranial solid malignancies than do white male children. Future efforts should be directed at understanding the causes of these differences and on developing practical clinical interventions to eliminate them. No significant financial relationships to disclose.