Abstract
Background: Conclusive information regarding the influence of race on survival among neuroblastoma patients is limited. Our objective is to investigate the association between race and cause-specific survival in pediatric patients diagnosed with neuroblastoma in the US between 1973 and 2015. Methods: This was a retrospective cohort study using the Surveillance, Epidemiology, and End Result (SEER) database. Patients aged 17 and younger of black, white, or Asian Pacific Islander (API) race diagnosed with neuroblastoma from 1973–2015 were included (n = 2,119). The outcome variable was time from diagnosis to death. Covariates included age, gender, ethnicity, stage, tumor site, and year of diagnosis. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals. Results: There were no statistically significant differences in the hazard of survival for blacks (HR 0.93; 95% confidence interval (CI) 0.74–1.16) or API (HR 1.02; 95% CI 0.76–1.37) compared with whites. However, patients diagnosed between 2000–2004 (HR 0.46; 95% CI 0.36–0.59) and 2005–2015 (HR 0.33; 95% CI 0.26–0.41) had decreased hazards of death when compared to patients treated during 1973 to 1999. Conclusions: No association between race and survival time was found. However, survival improved among all patients treated during 2000–2004 and 2005–2015 compared with those treated before the year 2000, leading to a narrowing of the racial disparity based on survival.
Highlights
Among the pediatric population, cancer is the leading cause of disease-related death [1].Neuroblastoma is the most common childhood cancer diagnosed during the first year of life, and the third most commonly diagnosed childhood cancer overall
The results showed no association between race and survival among pediatrics patients diagnosed with neuroblastoma, survival improved among all patients diagnosed after the year 2000
Kehm et al found that black neuroblastoma patients exhibited 38% higher risk of mortality compared with white patients after adjusting for age, sex, and stage of diagnosis [18]
Summary
Cancer is the leading cause of disease-related death [1].Neuroblastoma is the most common childhood cancer diagnosed during the first year of life, and the third most commonly diagnosed childhood cancer overall. Whites have a higher incidence of neuroblastoma than blacks and other races [5,6]. Conclusive information regarding the influence of race on survival among neuroblastoma patients is limited. Our objective is to investigate the association between race and cause-specific survival in pediatric patients diagnosed with neuroblastoma in the US between 1973 and 2015. Covariates included age, gender, ethnicity, stage, tumor site, and year of diagnosis. Results: There were no statistically significant differences in the hazard of survival for blacks (HR 0.93; 95% confidence interval (CI) 0.74–1.16) or API (HR 1.02; 95% CI 0.76–1.37) compared with whites. Survival improved among all patients treated during 2000–2004 and 2005–2015 compared with those treated before the year 2000, leading to a narrowing of the racial disparity based on survival
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