National Cancer Database Analysis Research Articles

Analysis of demographic and socioeconomic factors in mixed type rhabdomyosarcoma using NCDB.

e23538 Background: Mixed type rhabdomyosarcoma is a rare soft tissue tumor characterized by the presence of two histologically different subtypes of rhabdomyosarcoma, commonly found in the testis. Despite a majority of the patients undergoing aggressive treatment, the prognosis is poor. Analysis of its diagnostic trends could prove valuable in understanding mixed type rhabdomyosarcoma’s epidemiology. The 2004-2020 National Cancer Database (NCDB) was analyzed to determine the demographic factors of patients with mixed type rhabdomyosarcoma. Methods: A retrospective cohort analysis of the 2004–2020 NCDB, using ICD-O-3 code 8902/3, included patients diagnosed with mixed type rhabdomyosarcoma (N = 94). Descriptive statistics were used to analyze various demographic factors such as sex, age, race, Hispanic status, educational background, insurance status, facility type and location, distance from facility, and Charlson-Deyo score. Incidence trends were examined through regression analysis. Results: The NCDB identified a total of 94 patients with a confirmed diagnosis of mixed type rhabdomyosarcoma from 2004-2020, with a slight decline in incidences diagnosed per year (R² = 0.0903). Females had a slightly higher likelihood of being diagnosed (55%) compared to males (45%), with average age at diagnosis being 40.06 years (SD = 2.8, Range = 1-90). The majority of patients were White (72%) and of non-Hispanic descent (82%). The top primary site was the testis (23%), with endometrium being another major site (15%). Most (83%) patients had a Charles/Deyo comorbidity score of 0. All patients received immunotherapy as primary treatment. Most (46%) patients were privately insured. A majority (26%) of patients received treatment at an academic/research program. A greater number (53%) of patients resided in metropolitan counties with a population larger than 1 million. Most (40%) patients belonged to the highest quartile of income earners of $74,063 or greater. Conclusions: Our research on mixed type rhabdomyosarcoma, the first NCDB analysis of its kind, aims to address a notable knowledge gap on the topic. Similar to information presented in earlier studies, our analysis revealed mixed type rhabdomyosarcoma has a relatively poor prognosis and is mostly observed in White, Non-Hispanic individuals. Analysis on the demographics of this patient population revealed most patients were top quartile income earners, resided in a metropolitan location, and were more likely to be treated at an academic/research program. Further research should aim to better understand the impact of such demographic and socioeconomic features on the diagnosis, treatment plans, and overall mortality rates of patients with mixed type rhabdomyosarcoma.

Juxtacortical chondrosarcoma: An NCDB analysis of demographics and socioeconomic factors.

e23505 Background: Juxtacortical chondrosarcoma (JCC) is a rare cartilaginous tumor—accounting for less than 2% of all chondrosarcomas—and typically appears on the external surfaces of long bones. The prognosis of JCC is relatively promising compared to other chondrosarcomas, with the current therapy of choice being en-bloc resection. However, a significant amount of information regarding JCC remains unknown. Therefore, exploring diagnostic trends may provide greater insight into this cancer’s epidemiology and potential forms of treatment. The National Cancer Database (NCDB) was assessed to uncover the demographic factors in patients diagnosed with JCC. Methods: A retrospective cohort analysis utilizing the 2004–2020 National Cancer Database (NCDB) included 131 subjects with a histologically-confirmed diagnosis of JCC (ICD-0-3 code 9221). Demographic factors (age, sex, race, Hispanic status, insurance status, facility type, distance from facility, and Charleson-Deyo comorbidity score) were analyzed by descriptive statistics and incidence trends were interpreted in regression analysis. Results: Between 2004 and 2020, the NCDB reported a total of 131 patients with a confirmed diagnosis of JCC. This data indicated a rising incidence of patients diagnosed per year (R² = 0.0855), with an average age of diagnosis of 45 years (SD = 18, range = 8-88). Patients with JCC were more likely to be White (82%), of non-Hispanic origin (86%), and male (63%). The tumor was most commonly found in the long bones of the lower limbs (35%). Surgical removal was the primary treatment for the majority of patients (95%), while others received radiation (7%) or chemotherapy (4%). Most patients (83%) had a Charlson-Deyo comorbidity score of 0. Patients were commonly treated at academic and research facilities (61%), and no patients received palliative care. More than half of individuals were privately insured (57%) and resided in a metropolitan area with a population size of at least 1 million (59%). The mean distance between patient residence and treatment site was 104.1 miles (SD = 221, range = 11-1194 miles). Conclusions: To the best of our knowledge, this is the first study on juxtacortical chondrosarcoma utilizing NCDB data to address the significant lack of research on this subject. The majority of JCC patients are non-Hispanic, White, and have a primary site of diagnosis at the long bones of the lower limbs. This paper is the first to describe the socioeconomic factors of patients diagnosed with JCC: patients tend to be privately insured, live in large metropolitan areas, and are mostly treated in academic research facilities. Additional research is necessary to comprehend how socioeconomic and demographic factors influence the manner in which JCC patients are diagnosed and treated.

Small cell osteosarcoma: An NCDB analysis of demographic and socioeconomic factors of diagnosed patients.

e23504 Background: Small cell osteosarcoma (SCOS) is a rare subtype of osteosarcoma accounting for roughly 1.5% of all osteosarcomas. Its prognosis is slightly worse than conventional osteosarcoma. Exploring demographic trends in patients with a confirmed SCOS diagnosis may provide insight into its epidemiology and allow for earlier diagnosis. The National Cancer Database (NCDB) was analyzed to research the demographic factors in patients diagnosed with SCOS. Methods: A retrospective cohort analysis utilizing the 2004–2020 National Cancer Database (NCDB) included patients with a histologically-confirmed diagnosis of SCOS (ICD-O-3 9185). Demographic factors (age, sex, race, Hispanic status, educational attainment, insurance status, facility type, distance from facility, and Charles-Deyo score) were analyzed via descriptive statistics. Incidence trends were interpreted in regression analysis. The mean survival was compared using the Log Rank (Mantel-Cox) test. Results: A cohort of 102 cases of SCOS were retrieved from the NCDB between 2004–2020. The primary sites for SCOS were the long bones of the lower limb (41%). Most patients were male (69%), White (63%), non-Hispanic (84%) with a mean age for diagnosis of 28 (SD = 18). The mean survival for males was 117 months (95% CI [93,141]), more than twice as long as females with 58 months (95% CI [31,85]). The Log Rank (Mantel-Cox) test reported a chi-square (χ²) value of 6.434, indicating a statistically significant difference between survival curves of males and females (p = 0.01). Residence in a metropolitan area (86%) was more common than other rural or urban areas. The greatest proportion of patients lived in the Middle or South Atlantic region of the United States (68%). The majority of patients were insured (86%), with the most covered by private insurance (64%) or Medicaid (22%). The median household income for each patient was most commonly in the highest quartile of over $74,063 (29%). Patients were diagnosed with SCOS at a steady rate between 2004 to 2020 (R² = 0.0956). Using the AJCC Cancer Staging System, most patients were Stage II (40%) or Stage IV (21%) at diagnosis. As a primary treatment, 87% of patients received chemotherapy. Most patients (91%) had no comorbidities with a Charlson-Deyo score of 0. Conclusions: This is the first time that demographic and socioeconomic factors of SCOS patients have been analyzed from the NCDB, revealing that the mean survival time of patients after receiving a diagnosis was more than double for males than females. SCOS patients are also more likely to live in metropolitan areas, particularly within the Middle or South Atlantic United States. Consistent with earlier reports, SCOS is typically diagnosed in young adults in the long bones of lower limbs. To better understand the impact of demographic factors on the diagnosis, treatment, and overall survival of patients with SCOS, further research is recommended.

Demographics and socioeconomic factors of adenocarcinoma with apocrine metaplasia.

e12588 Background: Adenocarcinoma with apocrine metaplasia (AAM) is an invasive form of carcinoma distinguishable by the conversion of malignant glandular cells to apocrine sweat cells with abundant granular eosinophilia. Although AAM has a favorable prognosis, early treatment, including surgical intervention or radiation therapy, is still required to decrease metastasis or resurgence. Due to the rarity of this disease, the impact of demographic factors has not yet been explored and could be essential to understand its epidemiology. Demographic trends of patients were analyzed within the National Cancer Database (NCDB). Methods: Within this retrospective cohort analysis, 155 patients were identified from the 2004–2020 NCDB with a confirmed AAM diagnosis using code 8573 from the International Classification of Diseases for Oncology (ICD-8573-3). Their demographic factors including sex, age, race, Hispanic status, Charleson-Deyo score, distance to facility, educational attainment, and household income were analyzed using incidence trends and descriptive statistics via regression analysis. Results: The average age at diagnosis was 62.7 years (SD = 14.3, range = 18 - 90 years) with a 58% ten-year survival rate. The incidence steadily decreased from 2004–2020 (R2 = 0.3051). The majority of patients (85%) had no comorbidities (Charleson-Deyo = 0). Surgical treatment (73%) as a primary procedure was common and was combined with chemotherapy (57%) or radiation therapy (38%). The primary sites included the upper-outer quadrant (28%) and overlapping lesions of the breast (25%). The average tumor size at surgery was 30.7 mm (SD = 17.9 mm, range = 1.00–64.0 mm). The majority of patients were female (96%), White (72%), and non-Hispanic (88%). Patients tended to have household income greater than $57,857 (55%) and hailed from a metropolitan area with a population greater than 1 million (55%). The Western Central (53%) and Atlantic (24%) regions of the USA comprised most diagnoses. Patients traveled an average of 81.5 mi (SD = 184, range = 0.20–1110 mi) to receive care from an academic or research program (61%) or a comprehensive community cancer program (23%). Conclusions: The findings of this research support previous studies demonstrating that most patients tend to be over 60 years old and White. We reported an average tumor size of 30.7 mm, usually found in the upper-outer quadrant or overlapping regions in the breast. Patients typically underwent chemotherapy after surgical treatment at an academic hospital. Most patients lived in densely populated areas within the Western Central and Atlantic regions, which may suggest an ease of access to treatment. This is the first NCDB analysis of AAM, and thus fills an important gap in cancer research. Future work should identify the influence of demographic and socioeconomic factors on the diagnostic factors, cancer prognosis, treatment regimen, and overall survival rates of patients.

High-grade surface osteosarcoma: A National Cancer Database study of demographic characteristics.

e23508 Background: High-grade surface osteosarcoma (HGSO) is an extremely rare malignant subtype of osteosarcoma. HGSO often affects long bones, particularly the femur, and is the rarest subtype of surface osteosarcomas. Though data is limited, current information suggests this cancer presents with a poor prognosis, generally affecting adults aged 20 to 40. Current treatment standards involve wide resection and chemotherapy. The National Cancer Database (NCDB) was examined to establish the demographic factors among HGSO patients and identify diagnostic and treatment trends. Methods: A retrospective cohort study from 2005-2020 was conducted using the NCDB. A total of 99 patients were found with a histologically confirmed diagnosis of high-grade surface osteosarcoma (ICD-9194-3). Factors such as gender, age, race, insurance status, rural/urban residence, treatments, mortality rates, and Charles/Deyo scores were analyzed using descriptive statistics, and trends in incidence were interpreted via regression analysis. Results: Yearly HGSO incidence rates increased from 2005 to 2020 (R2 = 0.19). The average age of diagnosis was 41 years (SD = 24.9, range = 10-90) with men diagnosed (54%) slightly more than women. The majority of patients were non-Hispanic white (73%), had private insurance (55%), and lived in a metropolitan area with over 250,000 in population (89%). The average patient was diagnosed at a hospital 40.4 miles away from their home (SD = 84.9, range 0.4-648.4 miles). Most patients (55%) were in stage II at diagnosis, and 86% of patients had a Charlson-Deyo comorbidity score of 0. The most common primary site of this malignancy was the long bones of the lower limb and associated joints (67%), while the upper extremities (8%) and pelvic bone (8%) served as less common primary sites. Surgery was the most common primary treatment (62%). Data from 69 patients revealed the 90-day mortality post-surgery was 3%. The mean survival rate was 70% at two years and 52% at five years. Conclusions: To the best of our knowledge, this study represents the first NCDB analysis of HGSO. Our analysis demonstrated that HGSO occurs most often, but not exclusively, within the lower extremity long bones, which may be an important diagnostic distinction. It was previously indicated that the average age at HGSO diagnosis is 20-40 years, but our analysis suggested it is closer to 40. Our analysis revealed a five-year survival rate of 52% which is worse than prior studies have indicated. Demographic data has revealed the majority of patients were non-Hispanic white, privately insured, and living within a metropolitan area. This trend may suggest access to healthcare resources is influencing this cancer’s diagnosis and treatment. Further research is warranted to explore whether the demographic patterns seen in HGSO are indicative of biological causes or socioeconomic factors that are significantly influencing diagnosis.

Periosteal osteosarcoma: A study of demographic and socioeconomic factors.

e23506 Background: Periosteal Osteosarcoma (PO) is a rare primary malignant bone cancer that typically affects the tibia or femur of young adults in their second and third decades of life. This soft-tissue mass causes extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into soft-tissue components. Despite the rarity of PO, 29% of diagnosed patients do not survive past 10 years following treatment. Further investigation into the diagnostic trends of PO may produce valuable information about its epidemiology. The National Cancer Database (NCDB) was analyzed to identify the demographic factors of patients diagnosed with PO. Methods: A retrospective cohort analysis that utilized data from the 2004–2020 NCDB included 138 patients with a histologically-confirmed diagnosis of PO (ICD-9193-3). Demographic factors (age, sex, race, Hispanic status, educational attainment, insurance status, facility type, distance from facility, and Charlson/Deyo score were analyzed by descriptive statistics, and incidence trends were interpreted via regression analysis. Results: A total of 138 individuals had a confirmed diagnosis of PO between the years 2004-2020 with a relatively constant rate of diagnosis each year (R2 = 0.1749). The average age of diagnosis was 29.7 (SD = 17.5, range = 6-86 years). Males and females were affected at rates of 58% and 42%, respectively. The majority of patients diagnosed with PO identified as White (73%) and non-Spanish/non-Hispanic (86%). The primary sites of diagnosis were the long bones of the lower limb (77%), with an average tumor size of 94.4 mm (SD = 54.2). Most patients (73%) utilized surgical treatment options such as radical excision or resection of the lesion with limb salvage. A higher percentage of patients were privately insured (62%), lived in a metropolitan area (75%), and were treated at an academic/research program (59%). Many individuals (91%) had no concurrent comorbidities (Charlson-Deyo comorbidity score = 0). Following treatment, the survival rates of patients were 91% at 2 years, 78% at 5 years, and 71% at 10 years. Conclusions: To our knowledge, this is the first NCDB analysis concentrating on PO, addressing a substantial gap in our understanding. In congruence with earlier descriptions of PO in case reports, a majority of patients are White and of non-Spanish/non-Hispanic origin and the primary site of diagnosis presents on the lower limbs. This is the first instance in the literature where the socioeconomic factors of PO patients have been clarified: PO patients are more likely to live in densely populated metropolitan areas, receive treatment in academic programs, and have private insurance. Further research is needed to elucidate the influence of demographic and socioeconomic factors on the diagnosis, treatment approaches, and survival outcomes of individuals with PO.

Multiple myeloma in the African American population: A 2010-2020 NCDB analysis.

e19531 Background: Multiple myeloma (MM) exhibits a disproportionately higher prevalence among African American individuals. Various factors contribute to the disease's progression, severity, and prognosis. This analysis presents real-world data from the National Cancer Database (NCDB) from 2010 to 2020. Methods: Cohort of 241,446 MM patients between 2010 and 2020 were analyzed. Demographic variations, including age, gender, insurance status, educational attainment, and median household income, were examined. Multivariate Cox regression analysis was conducted to identify factors influencing survival outcomes. Results: Within the database, from 2010 to 2020, 51,668 cases of multiple myeloma were recorded among Black individuals. The age group most affected was 40 to 65 years (50.2%), followed by those over 65 (47.3%), with 2.5% falling between 18 to 40 years, and a mean age of 64.4 years. Most cases affected females (51.5%), with most households earning less than $40,227 annually. A significant portion of Black patients did not receive a transplant (83.8%) or immune based option (73.1%). The mean duration from diagnosis to therapy initiation was 37.5 days. Multivariate analysis revealed that patients over 65 had a worse prognosis (HR = 1.52, 95% CI: 1.47 – 1.57, P < 0.001) compared to those under 65, while females exhibited a better prognosis (HR = 0.88, 95% CI: 0.86 – 0.91, P < 0.001). Patients with private insurance had better outcomes (HR = 0.73, 95% CI: 0.68 – 0.78, P < 0.001), as did those treated in academic centers (HR = 0.89, 95% CI: 0.87 – 0.92, P < 0.001). Additionally, patients receiving any form of transplant had better outcomes (HR = 0.45, 95% CI: 0.42 - 0.49, P < 0.001), along with those undergoing chemotherapy (HR = 0.73, 95% CI: 0.68 – 0.78, P < 0.001) and immunotherapy (HR = 0.67, 95% CI: 0.64 – 0.69, P < 0.001). Conclusions: The analysis highlights significant demographic and treatment influences among African American patients with MM. Some identifiable factors associated with improved outcomes include younger age, female gender, private insurance, treatment in academic centers, and most importantly receipt of transplant and Immunotherapy. These findings underscore the importance of targeted interventions considering various factors and improving outcomes in this population. [Table: see text]

Characteristics and variations in young adults with cutaneous melanoma: A national cancer database analysis.

Many cancers in young adulthood differ in terms of biology, histologic variation, and prognosis compared to cancer in other older age groups. Differences in cutaneous melanoma among young adults compared to other older age groups, as well as between sexes in young adults are not well studied. The National Cancer Database was queried for patients diagnosed with cutaneous melanoma between 2004 and 2017. Patient characteristics, disease factors, and treatment were stratified by age-based cohorts and compared using standard univariate statistics. The Kaplan-Meier method and log-rank tests were used to evaluate overall survival (OS) between age-based cohorts and young adult sexes. Of the 329 765 patients identified, 10.5% were between 18 and 39 years of age at diagnosis. Compared with other older age groups, young adult patients were more likely to be female and uninsured with higher proportions of superficial spreading melanoma, melanoma of the trunk and extremities, and earlier-stage disease. Young adults had improved OS compared to other older age groups. Young male patients had a greater proportion of no insurance, nodular melanoma, higher-stage disease, and decreased OS compared to young female patients. Additionally, while the 5-year OS difference was statistically significant across all stages of disease between young males and females, the clinical significance is likely limited to later stages. Age and sex-specific differences in cutaneous melanoma highlight distinct patterns and characteristics, emphasizing the need for tailored approaches to screening, diagnosis, and treatment.

Trends in Early-Stage Cervical Cancer Management in the US: A National Cancer Database Analysis.

The Laparoscopic Approach to Cervical Cancer (LACC) trial was published in 2018 and demonstrated that minimally invasive surgery (MIS) yields inferior survival outcomes in early-stage cervical cancer compared to open surgery. This study investigates how the results of the LACC trial have impacted the selection of the primary treatment modality and adjuvant radiation utilization in early-stage cervical cancer. Using the National Cancer Database (NCDB), we compared patients with stage IA2-IB1 cervical cancer before (1/2016-12/2017) and after (1/2019-12/2020) the LACC trial. A total of 7930 patients were included: 4609 before and 3321 after the LACC trial. There was a decline in MIS usage from 67% pre-LACC to 35% thereafter (p < 0.001). In both the pre- and post-LACC periods, patients undergoing radical MIS more frequently had small volume disease (pre-LACC tumors ≤ 2 cm, 48% MIS vs. 41% open, p = 0.023; post-LACC stage IA2, 22% vs. 15%, p = 0.002). Pre-LACC, MIS radical hysterectomy was associated with White race (82% vs. 77%, p = 0.001) and private insurance (63% vs. 54%, p = 0.004), while there was no difference in socioeconomic factors in the post-LACC period. Although the proportion of patients treated with primary chemoradiation remained stable, the post-LACC cohort had a younger median age (52.47 vs. 56.37, p = 0.005) and more microscopic disease cases (13% vs. 5.4%, p = 0.002). There was no difference in the rate of radiation after radical hysterectomy before and after the trial (26% vs. 24%, p = 0.3). Conclusions: Post-LACC, patients were less likely to undergo MIS but received adjuvant radiation at similar rates, and primary chemoradiation patients were younger and more likely to have microscopic disease.

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A National Cancer Database Analysis.

Metastatic triple-negative breast cancer (TNBC) is aggressive with poor median overall survival (OS) ranging from 8 to 13 months. There exists considerable heterogeneity in survival at the individual patient level. To better understand the survival heterogeneity and improve risk stratification, our study aims to identify the factors influencing survival, utilizing a large patient sample from the National Cancer Database (NCDB). Women diagnosed with metastatic TNBC from 2010 to 2020 in the NCDB were included. Demographic, clinicopathological, and treatment data and overall survival (OS) outcomes were collected. Kaplan-Meier curves were used to estimate OS. The log-rank test was used to identify OS differences between groups for each variable in the univariate analysis. For the multivariate analysis, the Cox proportional hazard model with backward elimination was used to identify factors affecting OS. Adjusted hazard ratios and 95% confidence intervals are presented. In this sample, 2273 women had a median overall survival of 13.6 months. Factors associated with statistically significantly worse OS included older age, higher comorbidity scores, specific histologies, higher number of metastatic sites, presence of liver or other site metastases in those with only one metastatic site (excluding brain metastases), presence of cranial and extra-cranial metastases, lack of chemotherapy, lack of immunotherapy, lack of surgery to distant sites, lack of radiation to distant sites, and receipt of palliative treatment to alleviate symptoms. In the multivariate analysis, comorbidity score, histology, number of metastatic sites, immunotherapy, and chemotherapy had a statistically significant effect on OS. Through NCDB analysis, we have identified prognostic factors for metastatic TNBC. These findings will help individualize prognostication at diagnosis, optimize treatment strategies, and facilitate patient stratification in future clinical trials.

Abstract PS13-08: Chemotherapy in geriatric patients with early stage HER2+ breast cancer: A National Cancer Database analysis

Abstract Background Breast cancer (BC) incidence increases with age and women ≥ 65 years account for almost half of BC related mortality. Life expectancy has increased in the US due to improvements in medical care, and therefore the number of older patients with a BC diagnosis is also expected to increase. The population of individuals ≥ 80 years in the US is growing and now comprises more than 9 million. Approximately 15% of BC are human epidermal growth factor receptor 2 amplified (HER2+). The combination of chemotherapy with trastuzumab +/- pertuzumab compared with trastuzumab alone has been shown to be cost-effective in patients 70 years and older but trastuzumab monotherapy could be considered as an option in certain patients. Nevertheless, there is limited guidelines on how to properly care for the geriatric population with HER2+ BC. Methods We conducted a retrospective analysis of data collected from the National Cancer Database (NCDB). NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. Women ≥65 years with stage I, II and III HER2+ BC were included in the analysis. Patients were categorized into three treatment groups – those who did not receive chemotherapy or monoclonal antibodies (no-CT/mAbs), those who received chemotherapy in combination with monoclonal antibodies (CT/mAbs) and those who received monoclonal antibodies alone (mAbs). Using the Logrank P value, we explored the age cut off for which survival rates were not significantly different between treatment groups. Two comparisons were done: no-CT/mAbs vs CT/mAbs and CT/mAbs vs mAbs. The main outcome of this study was all-cause mortality. RESULTS: For the first comparison, a total of 9,924 HER2+ early-stage BC patients were included. Of these, 3,052 (30.8%) received no-CT/mAbs, while 6,872 (69.2%) received CT/mAbs. Kaplan Meier curves comparing mortality by treatment in the whole sample showed that those in the CT/mAbs group had significantly improved survival, compared to the no-CT/mAbs group (Logrank P &amp;lt; 0.001). The 1-year and 3-year survival rates were significantly higher in the CT/mAbs, compared to no-CT/mAbs. Cox proportional regression analysis showed that in the whole sample all-cause mortality was significantly lower among patients in the CT/mAbs group, compared to those in the no-CT/mAbs group (hazard ratio [HR], 0.48; CI: 0.41-0.57). However, the Logrank P values showed that there was no age cut off over which CT/mAbs did not improve survival compared to No-CT/mAbs. For the second comparison, a total of 7,457 patients were included. Of these 6,872 (92.2%) receive CT/mAbs and 585 (7.8%) received mAbs. The 1-year and 3-year survival rates were significantly higher in the CT/mAbs compared to the mAbs. The Logrank P values showed that there was no age cut off over which CT/mAbs did not improve survival compared to mAbs. Conclusion Chemotherapy in combination with HER2 directed monoclonal antibodies showed a survival benefit in elderly patients, irrespective of age, when compared to no-CT/mAb and mAb alone. These data highlight the importance of individualizing treatment recommendations and not forgoing standard therapy based merely on age. Limitations of the analysis include lack of available information on BC specific mortality. Also, the benefit that we identified could be secondary to selection bias. Additional studies are needed to improve the treatment in elderly patients with HER2+ BC. Table 1. Logrank P values for survival comparison between those who received CT/mAbs and No-CT/mAbs by age cut-off. Citation Format: Ana Sandoval-Leon, Yolcar Chamorro, Muni Rubens, Mukesh Roy, Lauren Carcas, Naomi Dempsey, Manmeet Ahluwalia, Reshma Mahtani. Chemotherapy in geriatric patients with early stage HER2+ breast cancer: A National Cancer Database analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS13-08.

Abstract PS13-07: Systemic therapy in geriatric patients with triple negative breast cancer: a National Cancer Database analysis

Abstract Background Breast cancer (BC) incidence increases with age and is the leading cause of new cancer diagnosis among women in the United States. Although the median age of diagnosis is 63 years (yrs.), over a third of patients diagnosed, and about half of BC mortality in Western societies are in patients over 70 yrs. old. Overall, outcomes for early-stage BC have improved. Despite the lower incidence of triple negative BC (TNBC) (12%-15%) the 5-year survival is 8% to 16% lower than in hormone receptor-positive BC. With the improved life expectancy in the US and the increased incidence of BC as patients age, it is of vital importance to know how to treat BC in the elderly. Unfortunately, optimal management of BC among the elderly has not been adequately studied due to underrepresentation in clinical trials. Furthermore, there is limited information of the potential toxicity and real benefit of chemotherapy in older patients. Methods This is a retrospective analysis of data collected from the National Cancer Database (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society, during the years 2004 to 2019. All women ≥65yrs with early stage TNBC (stages I-III) were included in the analysis. Patients were categorized into three treatment groups – those who did not receive chemotherapy (No-CT), those who received chemotherapy (CT), and those who received chemotherapy and immunotherapy (CTIO). After adjusting for multiple variables including race, insurance, Charleson-Deyo score, stage at diagnosis, and receipt of loco-regional therapy, using the log rank P value, the age cutoff over which the survival rates were not significantly different between two treatment groups (No-CT and CT/CTIO) was identified. The main outcome of this study was all-cause mortality Results A total of 11,416 women with TNBC were included in the analysis. Of these, 4105 (36.0%) received No-CT, while 7311 (64.0%) received CT/CTIO. Log rank P values showed that above 81 years, there was no survival benefit between No-CT and CT/CTIO. A further analysis categorized patients into two groups – those between 65-80yrs and those ≥81 yrs. old. Cox proportional regression analysis showed that among patients between 65-80 yrs. all-cause mortality was significantly lower among patients in the CT/CTIO group compared to those in the No-CT group (hazard ratio [HR], 0.52; CI: 0.45-0.60). However, among patients ≥81yrs old, there was no significant difference in all-cause mortality between the treatment groups (hazard ratio [HR], 0.84; CI: 0.67-1.05). Conclusions: Among patients who were &amp;gt;81yrs old with early-stage TNBC, those who received treatment with CT/CTIO did not have an overall survival benefit as compared to those who received No-CT. Limitations of this study includes the small number of patients &amp;gt;81yr old who received chemotherapy which could explain why we were not able to identify a statistically significant benefit of CT/CTIO. Another limitation is that we were not able to assess breast cancer specific mortality. However, this analysis highlights the importance of individualizing treatment recommendations in older patients, who may not garner the same benefit of treatment as younger patients. Additional studies are required to clarify contributing factors and to help optimize the management of geriatric patients with TNBC. Table 1. Patient characteristics based on treatment. Citation Format: Yolcar Chamorro, Muni Rubens, Mukesh Roy, Naomi Dempsey, Reshma Mahtani, Manmeet Ahluwalia, Lauren Carcas, Ana Sandoval-Leon. Systemic therapy in geriatric patients with triple negative breast cancer: a National Cancer Database analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS13-07.

Abstract PO1-17-10: Impact of COVID19 on neoadjuvant endocrine therapy use in breast cancer: A National Cancer Database analysis

Abstract Background: Neoadjuvant endocrine therapy (NET) is associated with similar response rates as neoadjuvant chemotherapy in hormone receptor positive (HR+) breast cancer (BC), with less toxicity. While gene expression assays such as the 21-gene recurrence score (RS) have led to decreased chemotherapy use in early HR+/HER2- BC, NET is often underutilized. In 2020, the COVID19 pandemic led to disruption in oncologic care, including cancellation of surgeries. Guidelines for BC management during the pandemic recommended NET for HR+/HER2- BC patients unable to obtain surgery due to pandemic restrictions. We evaluated NET use in 2020, compared to NET use in prior years. Methods: Female pts with nonmetastatic HR+/HER2- BC diagnosed between 2016 and 2020 were identified from the 2004-2020 National Cancer Database (NCDB). Annual number of pts receiving NET, and duration of use, were compared between years, and characteristics of pts treated with and without NET were evaluated within and across years, using Chi-squared test for categorical variables and Wilcoxon rank-sum test or Kruskal-Wallis test for continuous variables. Results: 554,733 pts met inclusion criteria; 84.50% white, 9.19% Black, 4.06% Asian; 5.88% Hispanic. 25,553 (4.61%) pts received NET. Annual NET use increased slightly between 2016 and 2018 [3.25% vs 3.49% (p=0.021) vs 3.89% (p &amp;lt; 0.0001)], remained stable in 2019 (3.98%), and then increased to 8.67% in 2020 (p &amp;lt; 0.0001). Median duration of NET remained relatively stable between 2016 and 2019 [74 days (d), 68d, 73d and 61d, 2016-2019] but declined in 2020 (56d, p&amp;lt; 0.0001 for 2020 vs 2016, 2017, 2018, and 2019). Older age and greater comorbidities were associated with NET use in all years (p &amp;lt; 0.0001). No racial association with NET use was seen in 2016-2018, but Black race was associated with greater NET use in 2019 (p=0.0122) and 2020 (p &amp;lt; 0.0001). Lobular histology, moderate grade, larger tumor size, and node involvement were associated with increased NET use in all years (p &amp;lt; 0.0001). Progesterone receptor positivity (PR+) and lower Ki67 were associated with NET use in 2020 (p=0.0007 and p&amp;lt; 0.0001), but not prior. Median tumor size for pts receiving NET was smaller in 2020 (16mm) compared with prior years (22, 23, 22, and 21mm for 2016-2019, p&amp;lt; 0.0001). Annual RS use increased for all pts between 2016 (34.59%) and 2020 (43.47%). RS use in NET pts was stable in 2016 (27.79%) and 2017 (27.54%), with modest increase in 2018 (29.56%; p 0.094, 2016 vs 2018, p=0.045, 2017 vs 2018), and then increased annually in 2019 (33.28%, p=0.0001) and 2020 (40.64%, p&amp;lt; 0.0001). Median RS was higher in pts receiving NET than in pts who did not in 2016-2019 (p=0.0078, 0.0003, 0.0271, and &amp;lt; 0.0001), but was similar in 2020 (RS=16; IQR 11, 22). Conclusions: Frequency of NET administration more than doubled in 2020, but duration was shorter than in prior years, possibly due to use of NET as “bridging therapy” due to COVID19 restrictions. Black race was associated with receipt of NET in 2020, possibly reflecting disparate impact of COVID19 on Black communities. NET use in 2020 was also associated with smaller tumor size, lower Ki67, and greater likelihood of PR+ disease than in prior years. Use of RS to guide NET increased annually, beginning in 2018. Association of NET with older age, greater comorbidities, higher stage, moderate grade, and lobular histology were seen in all years. Citation Format: Della Makower, Jaeun Choi, Susan Fineberg. Impact of COVID19 on neoadjuvant endocrine therapy use in breast cancer: A National Cancer Database analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-17-10.

A comparison of endoscopic endonasal versus open approaches for skull base chordoma: a comprehensive National Cancer Database analysis.

The authors of this study aimed to investigate independent prognostic factors of survival with a particular focus on comparing the safety and efficacy of endoscopic endonasal versus open approaches in the surgical management of skull base chordoma. A retrospective National Cancer Database review of skull base chordoma patients was performed to capture resection cases from 2010 to 2020, evaluating overall survival (OS), early postoperative mortality, readmission rates, and hospital length of stay (LOS) between surgical approaches and the independent prognostication of death utilizing Cox multivariate regression analysis. Among the 736 patients included in the cohort, 456 patients (62.0%) and 280 patients (38.0%) underwent endoscopic endonasal and open resection, respectively. These values represent a rate of change over the study period of +4.1 versus -0.14 cases per year, respectively. Gross-total resection was achieved in 32.5% of cases. A positive margin status was found in 51.8% of cases. There was no association between extent of resection and surgical approach (p = 0.257). There was no difference in OS (p = 0.562), 30- and 90-day mortality (p = 0.209 and 0.126, respectively), and 30-day readmission (p = 0.438) between the two surgical groups. The mean LOS was reduced by 2.1 days in the endoscopic cohort (p = 0.013) compared with the open approach cohort. Finally, multivariate analysis revealed a tumor size ≥ 4 cm (HR 4.03, p = 0.005) and public insurance (HR 2.76, p = 0.004) as negative predictors of survival and treatment at an academic center (HR 0.36, p = 0.043) as a positive prognosticator of survival. The endoscopic endonasal approach has been increasingly utilized over time and touts noninferiority with respect to safety and efficacy with a marked improvement in LOS, which carries substantial implications for both healthcare costs and enhanced patient recovery. Future prospective studies are necessary to further delineate trends and surgical outcomes for skull base chordoma.

Clinico–pathologic factors and survival of patients with breast cancer diagnosed with de novo brain metastasis: a national cancer database analysis

PurposePatients with Breast Cancer (BC) with Brain Metastasis (BCBM) have poor survival outcomes. We aimed to explore the clinico–pathologic and therapeutic factors predicting the survival in patients with de novo BCBM using the National Cancer Database (NCDB).Patients and methodsThe NCDB was queried for patients with BC between 2010 and 2020. Survival analysis with Kaplan–Meier curves and log rank tests were used to find median overall survival (OS) in months (95% CI) across the different variables. A multivariate cox regression model was computed to identify significant predictors of survival.ResultsOut of n = 2,610,598 patients, n = 9005 (0.34%) had de novo BCBM. A trend of decreasing OS was observed with increasing age, Charlson–Deyo score (CDS), and number of extracranial metastatic sites. The highest median OS was observed in the Triple Positive and the lowest OS in the Triple Negative subgroup. Based on treatment regimen, combination of systemic therapy and local therapy achieved the highest OS. A positive trend in OS was observed in the BC subgroup analysis with targeted therapy demonstrating a survival benefit when added to systemic therapy.The multivariate cox regression model showed that age, race, ethnicity, insurance, median income, facility type, CDS, BC subtype, metastatic location sites, and treatment combinations received were significantly associated with risk of death. Receiving only local treatment for BM without systemic therapy more than doubled the risk of death compared to combining it with systemic therapy.ConclusionsThis analysis suggests that treatment of systemic disease is the major factor influencing survival in patients with BCBM. Moreover, targeted therapy with anti–HER2 increased survival when added to systemic therapy explaining the highest median OS noted in the Triple Positive subgroup.

Delaying Surgery in Favorable-Risk Prostate Cancer Patients: An NCDB Analysis of Oncologic Outcomes

IntroductionConcern for overtreatment in very low-, low-, and favorable intermediate-risk prostate cancer has promoted a more conservative approach through active surveillance (AS) with comparable survival outcomes. We analyzed the National Cancer Database (NCDB) to determine if delaying radical prostatectomy greater than 6 months is associated with an increase in the rate of adverse pathology or secondary treatment (adjuvant or salvage) at radical prostatectomy. MethodsUtilizing the NCDB from 2004 to 2019, 40 to 75-year-old men with very low-, low-, and favorable-intermediate-risk prostate cancer, as defined by the National Comprehensive Cancer Network, were identified for this study. These individuals received radical prostatectomy either before or after 6 months following diagnosis. Clinical, demographic, and pathologic characteristics were obtained. Adverse pathologic outcomes were defined as pT3-4N0-1 and/or positive surgical margins. Multiple logistic regression models were used to predict delays in treatment, adverse pathologic outcomes, and receipt of secondary therapy. Survival analysis was performed using the Cox Proportional Hazards Model and the Kaplan-Meier Method. ResultsOf the 195,397 patients who met inclusion criteria, only 13,393 patients received surgery 6 months after diagnosis. The median time of delay was 7.5 months compared to 2.3 months in the immediate treatment group. Overall, delaying surgery had no statistically significant impact on adverse pathologic outcomes, regardless of risk category. However, when accounting for the interaction between race and delayed treatment, non-Hispanic black patients who received a delay in treatment were more likely to experience adverse features (OR 1.12, 95%CI 1.00-1.26, P = .041). Conversely, patients who had delayed surgery were less likely to receive additional therapy (either adjuvant or salvage) (OR 0.60, 95%CI 0.52-0.68, P < .001). Survival analysis showed that both groups fared well, with a 5-year survival of 97% for both groups. The treatment group was not predictive of survival. ConclusionOverall, delaying surgery more than 6 months following diagnosis did not have a significant impact on adverse pathologic features or overall survival. However, when specifically looking at non-Hispanic black patients with a treatment delay, these patients were at increased risk for adverse features, suggesting that the negative impact of treatment delay depends on the patient's race. As race is a social construct, this finding likely points to the complex socioeconomic factors that contribute to overall health outcomes rather than any inherent disease characteristics. Lastly, delayed treatment patients were actually less likely to require secondary therapy, regardless of race, possibly reflecting high clinician acumen in selecting patients appropriate for treatment delay. The results suggest that patients who ultimately “fail” AS and require subsequent surgery have overall comparable survival outcomes. However, pathologic outcomes are dependent on the patient's underlying race, with non-Hispanic black patients experiencing an increased risk of adverse outcomes if treatment is delayed.

Demographic Variations and Time to Initiation of Adjunct Treatment following Surgical Resection of Anaplastic Astrocytoma in the United States—A National Cancer Database Analysis

INTRODUCTION: Anaplastic Astrocytoma (AA) is a rare primary brain tumor with a significant variation in the type and timing of adjunct treatment (AT) following the surgical resection. METHODS: The National Cancer Database (NCDB) was queried for patients diagnosed with AA from 2004 to 2016. Cox proportional hazards and modeling was used to determine factors influencing survival, including the impact of time to initiation (TTI) of adjuvant therapy. RESULTS: Overall, 5890 patients were identified from the database. The use of combined RT+CT temporally increased from 66.3% (2004-2007) to 79% (2014-2016), p &lt; 0001. Patients more likely to receive no treatment following surgical resection included elderly (&gt;60 years old), hispanic patients, those with either no or government insurance, those living &gt;20 miles from the cancer facility, those treated at low volume centers (&lt;2 cases/year). AT was received following surgical resection within 0-4 weeks, 4.1-8 weeks, and &gt;8 weeks in 41%, 48%, and 3%, respectively. Compared to patients who received RT + CT, patients were likely to receive RT only as AT either at 4-8 weeks or &gt;8 weeks after the surgical procedure. Patients who received AT within 0-4 weeks had the 3-year OS of 46% compared to 56.7% for patients who received treatment at 4.1-8 weeks. CONCLUSIONS: Across the cohort, nearly 15% of patients received no AT following surgery, with the proportion of patients receiving no AT generally decreasing over time. This decrease corresponds to increased utilization of combined modality AT during the same time span. The highest utilization of combined AT within this cohort was between 4.1-8 weeks following the surgery.

Treatment Delay and HPV Status on OPSCC With Upfront Surgery: Analysis of National Cancer Database.

Evaluate the effect of treatment delay on survival in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing primary surgical resection. Retrospective cohort study using the 2010-2017 National Cancer Database. Multicenter database study. Patients >18 years old with OPSCC and known HPV status, treated surgically with or without postoperative radiation/chemotherapy were included. Two cohorts based on HPV status were grouped by time to treatment initiation (TD-TI, ≤30, 31-60, ≥61 days) and surgery to radiotherapy (TS-RT, ≤42, 43-66, ≥67 days). Univariate, Kaplan-Meier, and multivariate analyses assessed correlations between demographic and clinical factors with overall survival in treatment delay groups. Included were 1643 HPV-positive OPSCC patients and 391 HPV-negative OPSCC patients. No associations between survival and gender, age, race, insurance, or radiotherapy length were observed. Regardless of HPV status, larger tumor size (>2 cm) and lymphovascular invasion predicted worse survival. HPV negative patients with >4 lymph nodes involved had 2.5×greater mortality risk (P = .039). Robotic surgery was associated with improved survival only in HPV positive patients (hazard ratio [HR]: 0.41, P < .001). In HPV positive patients, higher TD-TI related to lower mean survival, although this was not significant on multivariate analysis. HPV negative patients with >42 days of TS-RT had decreased survival (43-66 days, HR 1.63, P = .049; ≥67 days, HR 2.10, P = .032). Longer TS-RT was associated with lower overall survival in HPV negative patients. Treatment delay was not associated with survival in HPV positive OPSCC according to multivariate analysis. These findings enhance knowledge about treatment delay effects in OPSCC, aiding providers in decisions and patient communication.

Abstract 6468: Nodular lymphocyte predominant hodgkin lymphoma: A national cancer database analysis with focus on hispanics

Abstract Background:Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare and distinct subtype of Hodgkin Lymphoma.(PMID 26149294) 80% manifest at early stages, with a male and black race predilection.(PMID 26149195) Previous analysis have shown similar survival of Hispanics (HI) compared to Non-Hispanics (NH).(J Clin Oncol 10.1200/JCO.2023.41.16_suppl.e19512) This National Cancer Database (NCDB) analysis aims to clarify how sociodemographic factors affect presentation and survival in HI vs NH patients with NLPHL. Methods:Data were analyzed on NLPHL patients in the United States reported to the NCDB 2004-2019. Demographic and treatment characteristics were compared between ethnic groups. Kaplan-Meier and Cox regression analyses were used to compare overall survival (OS) between HI and NH populations. Multivariate analysis and propensity score matching was performed. Results:Of 5517 of NLPHL patients, 379 were HI, and 4904 NH. Male gender and white race predominated for both. HI were diagnosed at a younger median age of 44 years (y) vs 48 y for NH, p=0.001. Most patients were diagnosed between years 2016-2019. Stage I predominated for both, p&amp;lt;0.001. As to Charlson-Deyo score ≥2, both HI and NH had 4%. Private insurance as primary payer was the most prevalent type for HI (53%) and NH (65%). HI had a higher percentage of unknown/uninsured, 12% vs 6% for NH, p&amp;lt;0.001. In relation to census median income (2008-2012), the most prevalent bracket for HI (27%) was $48,000-$62,000, and for NH (35%) was &amp;gt;$63,000. Regarding median income of &amp;lt;$38,000, HI were 29% vs 16% for NH, p&amp;lt;0.001. For median distance in miles (mi) between the patient’s residence and the hospital that reported the case (great circle distance), HI lived at a median of 6.3mi, vs NH at median of 9.5mi. Majority of HI (56%) were treated at Academic/Research programs; while most of NH (39%) were treated at Comprehensive Community Cancer programs, p&amp;lt;0.001. On survival analysis, the survival probability at 2, 5 and 10 y for HI was 96%, 92%, 86%, vs for NH was 96%, 92%, 84%, respectively. The median survival time wasn’t reached for both HI and NH, and no statically significant difference was seen, p=0.57. On multivariate analysis, HI was not associated with worse OS (HR 0.76, CI 0.44-1.31, p=0,33). The propensity matched analysis confirmed not reached OS on both cohorts. Conclusion:NLPHL is a disease that affects young males, at early stages, for both HI and NH. Unlike previous studies, in this analysis white race predominates; which could be explained by the increase in reported cases over years. Despite HI having more uninsured population with lower median income quartiles, this wasn’t a barrier to access care at academic/research programs. Although no difference in OS was seen among ethnicities, there is a tendency that might favor HI. More studies are needed to determine if specific demographic factors truly influence survival in NLPHL. Citation Format: Esteban Toro Velez, Daniel Rosas, Carolina Velez-Mejia, Qianqian Liu, Joel Michalek, Adolfo Enrique Diaz Duque. Nodular lymphocyte predominant hodgkin lymphoma: A national cancer database analysis with focus on hispanics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6468.

Abstract 3818: Sociodemographic, access to care and survival outcomes for patients with mantle cell lymphoma: A national cancer database analysis with focus on Hispanics

Abstract Background: Mantle cell lymphoma (MCL), represents 3% of new cases of non-Hodgkin’s lymphomas.(PMID 29348844) MCL affects mainly males; factors like ethnicity, age at presentation can have prognostic implications. Currently, it isn’t clear if Hispanics (HI) have a survival difference compared to Non-Hispanics (NH).(PMID 31029647, PMID 25315847). This National Cancer Database (NCDB) analysis aims to clarify how sociodemographic factors affect presentation and survival in HI vs NH patients with MCL. Methods: Data were analyzed on MCL patients in the United States reported to the NCDB 2004-2019. Demographic and treatment characteristics were compared between ethnic groups. Kaplan-Meier and Cox regression analyses were used to compare overall survival (OS). Multivariate analysis and propensity score matching was performed. Results: Of 32515 of MCL patients, 1729 were HI, and 29309 NH. Male gender and identification as white predominated for both. HI were diagnosed at a younger median age of 65 years (y) vs 68 y for NH, p&amp;lt;0.001. Most patients were diagnosed between years 2016-2019. Stage IV predominated for HI and NH, p&amp;lt;0.001. As to Charlson-Deyo Score ≥2, HI had 6% vs NH 8%. Government sponsored was the most prevalent primary payer, HI (54%) and NH (60%). HI had a higher percentage of unknown/uninsured, 13% vs 4% for NH, p&amp;lt;0.001. In relation to census median income (2008-2012), the most prevalent bracket for HI and for NH was &amp;gt;$63,000, 29% and 37% respectively. When analyzing median income of less than $38,000, HI were 22% vs 13% for NH, p&amp;lt;0.001. For median distance in miles (mi) between the patient’s residence and the hospital that reported the case (Great circle distance), HI lived at a median of 8.2mi, vs NH at median of 11.3mi. Most patients were treated at Academic/Research programs, 50% for HI and 39% for NH, p&amp;lt;0.001. On survival analysis, the survival probability at 2, 5 and 10 for HI was 74%, 57%, 44%, vs for NH was 72%, 54%, 36%, respectively. The median survival (MS) was 7.0 years for HI, vs 5.8 years for NH, with a statically significant difference in OS favoring HI, p=0.00015. On multivariate analysis, not insured status was independently associated with worse OS (HR 1.29, CI 1.08-1.55, p=0,01). The propensity matched analysis showed significant MS difference between HI vs NH (5.8 y vs. 5.6 y). Conclusion: In this analysis, MCL is a malignancy that presents at advanced stages, affecting mainly the elderly white males. HI compared to NH have a statically significant benefit in OS, which might be driven by a younger population with less comorbidities. Despite HI having limited access to insurance and lower income; sociodemographic differences don’t seem to be barriers for HI to access care at academic centers. Newer studies should focus on understanding what genetic and intrinsic disease factors cause HI to have an earlier presentation and a survival advantage over NH. Citation Format: Esteban Toro Velez, Carolina Velez-Mejia, Daniel Rosas, Qianqian Liu, Joel Michalek, Adolfo Enrique Diaz Duque. Sociodemographic, access to care and survival outcomes for patients with mantle cell lymphoma: A national cancer database analysis with focus on Hispanics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3818.