(P 209) RACE AND ETHNICITY ON DIAGNOSIS, METASTASIS, AND MORTALITY OF SOFT TISSUE SARCOMAS IN RETROSPECTIVE COHORT STUDY

Objective: Soft tissue sarcomas (STS) encompass a diverse array of rare tumors arising from mesenchymal tissues, exhibiting considerable histological diversity. Emerging research highlights the significant impact of race and ethnicity on survival outcomes, suggesting that genetic factors linked to ancestry could independently influence prognosis, regardless of socioeconomic factors. However, the current body of literature presents conflicting findings regarding mortality rates among different racial groups, underscoring the complex interplay between genetic predispositions, socio-demographic factors, and treatment outcomes in STS.

Methods: We conducted a retrospective cohort analysis using data obtained from electronic health records collected during routine care at Stanford Health Care from 2015 to 2024. Electronic Health Record data were mapped to the Observational Medical Outcomes Partnership Common Data Model version 5.3 such that International Classification for Diseases codes could be used to identify patients by their diagnosed conditions. We included patients 18-90 years old with a diagnosis of malignant neoplasm of connective and soft tissue. We examined patients of different races and ethnicities to evaluate the burden of disease from diagnosis, defined by whether metastatic disease was found within 3 months of diagnosis, and rates of mortality, including average time to death.

Results: We identified 1,350 patients consisting of 63.9% White, 14.5% Asian, 3.5% Black, and 18.1% Hispanic populations. The mean age of patients was highest in White patients at 60.5 years compared to other subgroups. The percentage of females within each subgroup analysis was roughly equal from 51.3-60%. Within 3 months of sarcoma diagnosis, metastatic disease was found in 25.53% Black, 13.06% Hispanic, 10.56% of White, and 5.61% of Asian patients. Rates of mortality were highest at 7.4% in White and lowest at 2.55% in Asian patients. Rates of mortality compared between the White population and other races and ethnicities when propensity matched was only significant when compared to the Asian population having lower rates of mortality (p = 0.02). The average time to death was lowest in the Black population at 180.47 days.

Conclusion: Our retrospective cohort analysis revealed significant racial and ethnic disparities in disease burden and mortality outcomes. Metastatic disease within 3 months of diagnosis was disproportionately higher among Black and Hispanic patients, indicating potential deficiencies in initial diagnostic access and timely surgical intervention. Moreover, the Black population exhibited the shortest average time to death, underscoring an urgent need for tailored interventions. Conversely, mortality rates were most elevated in White patients, with the lowest observed in Asian patients, revealing a statistically significant differential between these groups. These findings underscore the importance of considering racial and ethnic factors in the prognosis and treatment of STS to address these disparities and improve outcomes for all patient groups. Further research is needed to understand the underlying causes of these differences and to develop strategies to mitigate racial and ethnic disparities in care for STS patients.