An overview of survival and demographic disparities in primary peritoneal carcinoma: Insights from Surveillance, Epidemiology, and End-Results (SEER) database (2000 to 2021).

Abstract

e23346 Background: Primary peritoneal carcinoma (PPC) is a rare and aggressive malignancy arising from the peritoneal lining with minimal or no ovarian involvement. PPC is associated with high morbidity & mortality due to advanced disease at presentation and lack of generalized treatment guidelines. We investigated the impact of sociodemographic factors on survival. Methods: A retrospective analysis was performed on patients from the SEER database diagnosed with PPC from 2000 to 2021. Kaplan-Meier method was used to evaluate survival probabilities while considering censored data. Statistical tests using log-rank and Wilcoxon were used to compare survival among different groups. Results: 2,526 patients were included in the analysis. In the cohort, 75.18% were non-Hispanic White (NHW), 11.92% Hispanic, 7.72% non-Hispanic Asian or Pacific Islander, 4.59% non-Hispanic Black, and 0.51% non-Hispanic American Indian/Alaska Native. Highest proportion of patients were from areas with a median household income between $70,000 & $74,999 (17.58%). Only 0.87% were from areas with incomes below $40,000. A significant proportion of patients (62.79%) resided in counties within metropolitan areas with populations exceeding 1 million. Only 4.55% lived in nonmetropolitan, nonadjacent counties. Treatment delays were observed in a notable proportion of patients, with only 19% being initiated on treatment on the day of diagnosis. Histology was used for diagnostic confirmation in 93.82% of cases, with remaining 6.18% confirmed via cytology. Most patients (55.54%) were diagnosed at a distant stage, while localized cases constituted only 10.53%. Survival time ranged from 0 to 263 months (mean: 42.74 months). Overall, of the 2,526 patients, 1,855 died, resulting in a mortality rate of 73.44%. Kaplan Meier's analysis revealed that marital status showed a significant impact on survival, with widowed and single patients exhibiting poorer outcomes (p < 0.0001). Despite initial differences in rural-urban survival probabilities, these differences were not statistically significant (p = 0.3993). Conclusions: Sociodemographic disparities were observed with a major proportion of patients belonging to NHW, median household income between $70,000 & $74,999, and geographically located in counties in metropolitan areas with populations exceeding 1 million.Poorer outcomes in widowed and single-marital status highlight the need to provide more robust support services to this vulnerable group. Geographic disparities, while not statistically significant, may suggest variations in access to diagnostic modalities, particularly between rural and metropolitan areas. Distant stage diagnosis and delayed treatment may further exacerbate poor survival outcomes. Targeted efforts are needed to address inequities and to ensure equitable cancer care.