A. Braswell1, V. Jiminez1, K. Montgomery2, N. Garcia1, C. Amu-Nnadi4, K. Broman2,3, V. Eulo5 1University Of Alabama at Birmingham, Heersink School Of Medicine, Birmingham, Alabama, USA 2University Of Alabama at Birmingham, Department Of Surgery, Birmingham, Alabama, USA 3University Of Alabama at Birmingham, Institute For Cancer Outcomes And Survivorship, Birmingham, Alabama, USA 4The State University of New Jersey, Rutgers, New Brunswick, NJ, USA 5University Of Alabama at Birmingham, Department Of Medicine, Birmingham, Alabama, USA
Introduction: Soft tissue sarcomas are relatively uncommon, representing less than 1% of malignancies, and can arise due to genetic predisposition, environmental exposures, or secondary to other treatments. Grade, determined by histological characteristics, is one of the most important prognostic factors with high-grade tumors having poorer outcomes. Substantial variation exists regarding incidence of high-grade soft tissue sarcoma, particularly in certain patient populations. This study examines racial and ethnic variation in incidence of soft tissue sarcoma in a Southeastern US population with a large rural-dwelling Black population.
Methods: The retrospective cohort included patients with high-grade soft tissue sarcoma who were seen at our tertiary care center, a regional referral center for patients living in the Southeastern US, between January 1, 2016 and December 31, 2021. Patients were identified using cancer registry and billing data. Sociodemographic characteristics, treatments, and oncologic outcomes were evaluated using descriptive statistics.
Results: There were 328 patients, of whom 57% were female and mean age was 66. The cohort was 70% White, 26% Black, and 4% other. There was greater representation of Black individuals than in national cohorts, among which Blacks comprise approximately 12%. The most common histologies were leiomyosarcoma (26%), undifferentiated pleomorphic sarcoma (22%), and liposarcoma (14%). Almost half of patients in this cohort developed metastatic disease at some point during the study period, with greater than 20% of patients presenting with metastasis at initial diagnosis. 82% of the cohort underwent surgical resection of their sarcoma with fewer patients receiving neoadjuvant or adjuvant chemotherapy (23%) than neoadjuvant or adjuvant radiation (53%) as part of their treatment plan. Median survival was less than two years, suggesting an overall poor prognosis for patients with these high-grade neoplasms.
Conclusion: Results from this study describe the racial incidence and outcomes of high-grade soft tissue sarcoma in the southeastern US. Further work will evaluate differences in racial distribution by histology and compare with national data.
