Abstract 61P
Background
Strong evidence supports the impact of gender and race/ethnic background on patients (pts) outcomes across several cancer types. Here we present a comprehensive analysis of the Surveillance, Epidemiology, and End Results database (SEER 1975-2016) in BC.
Methods
53718 pts with BC (22068 gallbladder, 12502 intrahepatic bile duct, 16111 extrahepatic bile duct, 3037 unspecified) were included. Primary end point was 5-year survival probability. Log-rank tests were used to evaluate the effects of gender and race/ethnicity on overall survival (OS). Subgroups analyses included primary tumor site, disease stage, and treatment.
Results
43% of pts in our series were male (M) and 57% female (F); 66% were White/Caucasian (W), 15% Hispanic (H), 11% Asian (A), 8% Black/African American (BA). Significant differences in baseline pts characteristics were found between M and F for: age of diagnosis (68 vs 70 yr), stage (25 vs 28% local disease), primary tumor site (38% extrahepatic in M, 50% gallbladder in F), surgical treatment (39 vs 47%), P < .001. Significant differences in gender proportions and age were observed across race/ethnic groups, with youngest mean age at diagnosis and highest prevalence of F pts in H (66 yr, 64%) and BA (66 yr, 61%). Overall, F pts had higher 5-year OS probability compared to M (0.13 vs 0.11, P < .001). This difference was significant regardless of age in F, however, younger F pts showed higher OS probability rates (0.23 in age <50 vs 0.13 in age ≥ 50 yr, P < .0001). Among race/ethnic groups, higher 5-year OS probability was observed for H and A while lower for BA and W (0.16 vs 0.14 vs 0.13 vs 0.12, P < .0001). The gender related survival difference was largest in H (0.17 vs 0.13, P < .001) but was also significant in BA (0.13 vs 0.11, P = .01); no significant difference was found in W and A. When stratified by both gender and ethnicity, the highest survival probabilities were observed for H and A female pts, the lowest for W and BA males (0.17 vs 0.15 vs 0.11 vs 0.11, P < .0001). A subgroup analysis in the metastatic setting showed the lowest 5-year OS probability in BA female pts (0.05), the highest in H (0.07, both M and F) and A females (0.07).
Conclusions
Our data show that outcomes of BC differ by gender and race/ethnicity, favoring F gender and Hispanic and Asian ethnicity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
National Cancer Institute grant number P30CA014089, the Gloria Borges WunderGlo Foundation-The Wunder Project, the Dhont Family Foundation, the San Pedro Peninsula Cancer Guild, the Daniel Butler Research Fund, the Call to Cure Research Fund and the Fong Research Project.
Disclosure
H.J. Lenz: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Serono; Honoraria (self), Advisory/Consultancy: Roche; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Bayer; Advisory/Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy: GlaxoSmithKline; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Isofol Medical. A.B. El-Khoueiry: Honoraria (self), Advisory/Consultancy: CytomX Therapeutics; Honoraria (self), Advisory/Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy: Bayer; Honoraria (self), Advisory/Consultancy: Eisai; Honoraria (self), Advisory/Consultancy: Roche/Genentech; Honoraria (self), Advisory/Consultancy: EMD Serono; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Merck; Honoraria (self), Advisory/Consultancy: Exelixis; Honoraria (self), Advisory/Consultancy: Pieris Pharmaceuticals; Honoraria (self), Advisory/Consultancy: Agenus; Honoraria (self), Advisory/Consultancy: Gilead Sciences; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): AstraZaneca/MedImmune; Research grant/Funding (self): Astex Pharmaceuticals; Advisory/Consultancy: Novartis; Advisory/Consultancy: BMSCelgene. F. Battaglin: Travel/Accommodation/Expenses: Caris Life Sciences. All other authors have declared no conflicts of interest.