Abstract B096: Predictors of survival in black and white patients with malignant pleural mesothelioma

• Published in: Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2020-06, Vol.29 (6_Supplement_2), p.B096-B096
• Main Authors: Alpert, Naomi, van Gerwen, Maaike, Ohri, Nisha, Flores, Raja, Taioli, Emanuela
• Format: Article
• Language: English
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1538-7755.DISP19-B096

Purpose: Malignant pleural mesothelioma (MPM) is a rare cancer, particularly among black patients, with a very poor prognosis. There is only one study directly examining prognostic factors of survival in white and black patients with MPM, based on SEER. The goal of this study was to use a large, nationwide cancer database to examine factors associated with survival in black and white patients with MPM. Methods: We used the National Cancer Database (NCDB) to identify black and white patients diagnosed with MPM from 2004-2013. Multivariable Cox proportional hazards models, stratified by race, were used to assess factors associated with overall survival (OS), using adjusted hazards ratios (HRadj) and 95% confidence intervals (CI). Covariates included age, gender, ethnicity, zip-code level education and income, insurance, Charlson-Deyo comorbidity score, histology, laterality, stage, receipt of treatment (surgery, chemotherapy, radiotherapy), hospital characteristics, and year of diagnosis. Results: There were 15,828 patients included; 15,109 white (95.5%) and 719 black (4.5%). After adjustment, black patients were significantly younger, living in areas characterized by lower educational attainment and income, more likely to be on Medicaid, to be from the South and to live closer to their hospital. Though not significant, black patients were less likely to receive surgery, radiotherapy, and chemotherapy than white patients. There were several differences in factors associated with OS for black and white patients. OS was significantly worse for older patients, but the association was stronger in black patients (HRadj [white]: 1.86, 95% CI: 1.56-2.21; HRadj [black]: 7.18, 95% CI: 3.39-15.20 for ≥80 vs.