Examining the impact of socioeconomic factors on survival and treatment outcomes in primary intraocular lymphoma: Insights from the SEER database (2000–2021).

Abstract

e19080 Background: Primary Intraocular lymphoma (PIOL) is a subset of primary central nervous system lymphoma, with increasing incidence and a poor prognosis. While it is known that health disparities exist across ocular oncology, there is limited research on the effect of socioeconomic factors on treatment in PIOL. The aim of this study is to investigate the importance of health equity in PIOL by evaluating the role of socioeconomic factors on survival and surgical treatment outcomes. Methods: Ocular lymphoma patients from the Surveillance, Epidemiology, and End Results (SEER) were selected from 2000-2021. Covariates included age, gender, race, stage, tumor size, median household income, and population size of the patient’s home area. Cox regression analyses were completed to compare survival. Logistic regression compared factors associated with receipt of surgery. Results: A total of 3,756 patients were included. On Cox regression, there was improved survival for patients who were diagnosed with PIOL more recently (2016-2021) (p=0.013, HR=0.621), received radiation therapy (p<0.001, HR=0.582), and surgery (p=0.004, HR=0.621). Age over 65 (p<0.001, HR=4.919), diagnosis at distant staging (p<0.001, HR=2.404), and receiving chemotherapy (p<0.001, HR=1.804) were associated with worse survival. Logistic regression showed that patients who received chemotherapy (p=0.012, OR=0.775) and patients living in non-metropolitan areas (p=0.003, OR=0.622) were associated with a lower rate of surgery. Conclusions: This study assessed the impact of socioeconomic factors including age, race, household income, and living location on PIOL survival and treatment. Tumor stage and year of diagnosis were also analyzed. Diagnosis of PIOL from 2016-2021, receiving radiation therapy, and undergoing surgery had improved survival. Worse survival was associated with age over 65, distant staging, and those who received chemotherapy. Patients who received chemotherapy and lived in non-metropolitan areas had decreased rates of receiving surgical treatment. Evaluating barriers to care is important to determine how to improve survival and how to increase health equity across different patient populations. Future research should prioritize addressing obstacles to accessing care in order to improve outcomes for patients with PIOL.