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Disparities in Surgical Oncologic Care

Quality & Disparities Parallel Session

33: Racial Disparities Among Histologic Subtypes and Clinical Outcomes in Retroperitoneal Liposarcoma

Saturday, March 23, 2024

8:32am – 8:42am ET

Location: C102

Abstract Presenter(s)

Noor Habboosh, MD (she/her/hers)

Surgical Oncology Research Fellow; Surgical Resident
Memorial Sloan Kettering Cancer Center; Montefiore Medical Center/Albert Einstein College of Medicine, United States

Submitter(s)

Noor Habboosh, MD (she/her/hers)

Surgical Oncology Research Fellow; Surgical Resident
Memorial Sloan Kettering Cancer Center; Montefiore Medical Center/Albert Einstein College of Medicine, United States

Author(s)

PP

Priyanka Parmar, MD

Surgical Resident
Montefiore Medical Center/Albert Einstein College of Medicine, United States
RJ

Rajika Jindani, MD

Surgical Resident
Montefiore Medical Center/Albert Einstein College of Medicine, United States
KP

Katia Papalezova, MD

Attending - Surgical Oncology
Montefiore Medical Center/Albert Einstein College of Medicine, United States

Disclosure(s):

Noor Habboosh, MD: No financial relationships to disclose

Introduction: Retroperitoneal sarcomas account for 16% of all soft tissue sarcomas, with several histologic variants, each with distinct tumor biology. Liposarcoma (LPS) is the most common type, and encompasses several histologic subtypes, which have been associated with differences in local recurrence, distant metastasis, and mortality. While histologic subvariants are associated with disparate clinical prognoses, previous studies have not characterized potential racial disparities among either histologic subtypes or clinical outcomes in retroperitoneal LPS.

Methods: Patients who were diagnosed with primary retroperitoneal sarcoma between 2010-2020 at age >25 were identified from the Surveillance, Epidemiology, and End Results Program (SEER) database (n=3,470). Univariate analysis was performed with chi-squared tests, and multivariable analysis was performed with Cox regression.

Results:
1,990 (57.3%) cases were classified as LPS, of which 606 (30.5%) were well-differentiated (WDLPS), 887 (44.6%) de-differentiated (DDLPS), 77 (3.9%) myxoid/round cell LPS, 114 (5.7%) pleomorphic LPS, and 284 (14.3%) nonspecific LPS. Of these patients, 1275 (64.1%) self-identified as White, 110 (5.5%) Black, 310 (15.6%) Hispanic, 24 (1.21%) Asian/Pacific Islander, 3 (0.15%) American Indian/Alaskan Native. Higher grade LPS (DDLPS, myxoid/round cell, pleomorphic) was associated with increased overall (aRR 1.91, 95%CI 1.86-1.93, p< 0.01) and disease specific (aRR 2.62, 95%CI 2.55-2.63, p< 0.001) mortality (DSM). Black race was associated with a lower rate of more advanced grade LPS histologic variants; (52.9%, aRR 0.84, 95%CI 0.72-0.91, p< 0.01). There was no statistically significant association between White or Hispanic race and rate of high grade LPS. While the majority of DSM in Black (77.8%), Hispanic (78.4%), and White (81.3%) patients was secondary to higher grade histologic subtypes, race was not significantly associated with DSM or overall mortality. Among high grade subtypes, Black (aRR 1.24, %95CI 1.20-1.25, p< 0.01) and Hispanic (aRR 1.10, %95CI 1.09-1.14, p< 0.01) patients experienced greater disease-specific mortality.

Conclusions:
Higher grade retroperitoneal liposarcoma is associated with a higher rate of disease specific mortality; race is not predictive of specific histologic subtypes or DSM. However, among patients with high grade histologic subtypes, Black and Hispanic patients experience significantly greater DSM. This analysis highlights the importance of further characterizing disparities in treatment for Black and Hispanic patients with LPS.
Learning Objectives:
describe the relationship between retroperitoneal liposarcoma histologic subvariant and clinical outcomes.
describe the relationship between race and histologic subvariant in retroperitoneal sarcoma.
identify the discrepancy between racial disparities in retroperitoneal sarcoma outcomes and the lack of correlation between race and histologic subtype.