Disparities in mycosis fungoides outcomes: A multivariate survival and prevalence study.

Abstract

e19117 Background: Mycosis fungoides (MF) is the most common type of cutaneous T cell lymphoma. It is characterized by the infiltration of malignant T-cell clones into the skin. The diagnosis can be challenging and requires careful clinicopathological correlation. The purpose of this study is to determine sociodemographic disparities and survival trends in patients with MF. Methods: Total 10450 cases of MF were collected from SEER Plus Database, 17 Registries, Nov 2024 Sub (2000-2022), using the ICD Code 9700/3. A multivariate Cox regression model was used to examine the effects of independent variables including age [continuous variable], sex [reference=males], race [ref=Caucasians], year of diagnosis [continuous variable], stage [ref=locoregional], median household income inflation adjusted to 2023 [ref= <100K], and treatment including surgery, chemotherapy (CTX), XRT [ref=no Tx utilized, respectively] on the survival. Dependent variables were survival (months) and an event (1=death, 0=censored). All analysis was conducted using GraphPad Prism 10.6.1. Results: Of the dataset, 57.6% were males. Racial distribution was: 60.6% Caucasians and 39.4% non-Caucasians races. Median age was 66 years. The overall median of survival was 255 months, with a 1-year OS of 95.99% (CI 95%, 95.6%-96.4%) and 5-year OS of 82.95% (CI 95%, 82.14%-83.7%). The overall Cox proportional hazards model for multivariate analysis was statistically significant (p < 0.05). The results of the model are shown in Table 1. Conclusions: Our analysis showed that for every 1-year increase in age, the hazard of death increased by 7.7%. While the risk of death reduced by 2.2% for every following year from 2000 to 2022 as the year of diagnosis. Females had 23% less risk of death compared to males. However, non-Caucasian origin was associated with 1.25-fold increased risk and distant stage with 2.84-fold increased risk of death compared to Caucasian origin and locoregional disease, respectively. Income above 100K showed 0.74-fold risk compared to those making less than 100K. Chemotherapy showed 1.82-fold higher hazard risk and XRT showed 1.74-fold higher risk of death compared to no CTX and no XRT, respectively. Higher risk with CTX and XRT are likely attributed to their use in advanced disease states rendering higher HR in those cohorts of patients. No significant association was found between surgical management with survival. Higher HR with treatment warrants exploration of targeted chemoimmunotherapy based on next generation sequencing to mitigate the overall risk. Variables HR 95% CI P value Age 1.077 1.074 – 1.081 <0.0001* Gender [female] 0.771 0.713 – 0.833 <0.0001* Race [non-Caucasians] 1.252 1.151 – 1.36 <0.0001* YOD 0.978 0.9707 – 0.9852 <0.0001* Stage [distant] 2.843 2.25 – 3.54 <0.0001* Surgery [yes] 1.018 0.927 – 1.116 0.7065 Chemotherapy [yes] 1.816 1.67 – 1.975 <0.0001* XRT [yes] 1.735 1.56 – 1.924 <0.0001* Income [>100K] 0.743 0.68 – 0.81 <0.0001*