The role of race and economic characteristics in the presentation and survival of patients with surgically-resected non-small cell lung cancer.

Abstract

e20053 Background: To investigate the inter-relation between economic, marital, and known histopathologic/therapeutic prognostic factors in presentation and survival of surgically-resected lung cancer patients in nine different ethnic groups. Methods: A retrospective review of the SEER database was conducted through the years 2007-2012. Population differences were assessed via chi-square testing. Multivariable analyses(MVA) were used to detect overall survival(OS) differences in the total surgical population (TS, N = 35,689) and in an early-stage (T1-T2 < 4cm N0) surgically-resectable population(ESR, N = 17,931). Results: In the TS population, as compared to Whites, Blacks and Hispanics were more likely to present with younger age, adenocarcinomas, less married partnerships, no insurance, fewer stage I tumors, and fewer nodes examined, but their surgical procedure types and OS/LCSS were the same. MVA demonstrated that lower OS was associated with males, single/divorced/widowed partnership, lower income(TS only), and Medicaid insurance. MVA also found that all ethnic groups had a similar (Hispanics, Blacks) or better OS compared to Whites. 90-day mortality and positive nodes were correlated with not having insurance and not being married, but not ethnicity. Conclusions: In TS and ESR groups, OS was not different in the two largest ethnic groups (Black, Hispanic) as compared to Whites, but was related to single/widowed/divorced status, Medicaid insurance, and income (TS group only). Nodal positivity was associated with patients who did not have a married partner or insurance suggesting that psycho-social variables may impact disease biology in addition to the known histopathologic and treatment variables in patients undergoing surgical resection of early-stage lung cancer.