Variation in survival rates among patients with angiosarcoma based on demographic and socioeconomic factors in academic versus non-academic settings: An NCDB analysis.

Abstract

e23537 Background: Angiosarcomas are malignancies of endothelial-cell origin representing 2% of soft-tissue sarcomas. Although the number of cases of angiosarcoma continues to rise, the prognosis is generally poor and treatment options remain limited. Due to the rarity of angiosarcoma and limited available literature, this study is intended to analyze the impact of demographic and socioeconomic factors on patients’ survival rates in academic versus non-academic settings. Methods: We performed a retrospective analysis of 5,544 patients diagnosed with angiosarcoma from the National Cancer Database (NCDB) between 2004-2017. Patients were stratified by facility type and compared via Kaplan-Meier analysis, log-rank test, chi-square analyses, and ANOVA. Additionally, a cox proportional hazards multivariate regression model was used. The following demographic factors were examined: age, sex, reported race and ethnicity, mean survival rates utilizing the Charlson Comorbidity Index, facility type where patients received treatments, and treatment modalities. Furthermore, the assumption of proportionality was tested for each variable. Data was analyzed using Statistical Analysis Software (SAS). Results: Higher rates of death were seen in those of male sex, African American race, increased age (> 72), and increasing Charlson-Deyo scores. There was an increased risk of death for older African American males with non-zero Charlson-Deyo scores. Additionally, patients from areas of increased income had decreased rates of death. After adjusting for most variables, patients who were treated at academic facilities had an 8.5% decreased risk of death compared with patients treated at non-academic facilities (95% CI: 1.5% to 15.0%; P = 0.019). Conclusions: Our study results indicate that certain demographic and socioeconomic factors may be linked to poorer survival outcomes in patients with angiosarcoma. Further investigation of socioeconomic barriers and prognostic factors for angiosarcoma may help to identify populations at risk for poor treatment outcomes and guide disease management.