Stromal sarcoma, NOS: A National Cancer Database analysis of patient demographics and survival.

Abstract

e17637 Background: Stromal sarcoma (SS) is a rare malignancy of connective tissue, with endometrial stromal sarcoma representing approximately 10% of uterine sarcomas. SS typically occurs in patients aged 40-50, and its rarity necessitates comprehensive epidemiological investigation. This study leverages the National Cancer Database (NCDB) to investigate the demographic characteristics and clinical patterns of patients diagnosed with SS. Methods: A retrospective cohort study was conducted using the NCDB from 2004 to 2020, analyzing 887 patients with histologically confirmed stromal sarcoma (ICD-O-3 code 8935). Demographic variables were assessed: age, sex, race, Hispanic status, education level, insurance type, treatment facility characteristics, patient travel distance, and Charlson-Deyo comorbidity score. Descriptive statistics and regression analysis were employed to interpret incidence trends and patient characteristics. Results: A total of 887 patients with stromal sarcoma were identified, predominantly female (92.3%), with a mean age at diagnosis of 55.8 years (SD = 14.4, range 17-90). Patients were primarily white (77.3%), non-Hispanic (86.8%), and residing in metropolitan areas with populations exceeding 1 million (57.4%). Treatment approaches were diverse, with 22.3% receiving primary radiation therapy and 21% undergoing chemotherapy. A significant proportion of patients (25.6%) did not undergo surgical resection, and 62.3% showed no residual tumor post-surgical intervention. The most common primary site was the endometrium (45.8%). Treatment facilities included academic/research programs (34.7%) and comprehensive community cancer programs (30.9%). The majority of patients (83.4%) had a Charlson-Deyo comorbidity score of 0, and 97.0% received no palliative care. Patients traveled an average of 31.2 miles (SD = 117.5, range 0-2,285.7) for treatment, with 36.9% belonging to the top income quartile and 58.5% privately insured. Conclusions: This study represents the first comprehensive analysis of stromal sarcoma using the National Cancer Database, addressing a significant knowledge gap in understanding this rare malignancy. The majority of stromal sarcoma patients were female and white, with a primary site diagnosis in the endometrium, treated primarily at academic or community cancer programs. This analysis reveals a distinct socioeconomic profile, with patients concentrated in the top income quartile, predominantly privately insured, and residing in large metropolitan areas. Future research should prioritize developing personalized treatment strategies through targeted investigations, including identifying specific clinical biomarkers for predictive prognostics, exploring genetic mechanisms of disease progression, and developing targeted therapeutic approaches to optimize treatment plans.