title: Poorer prognosis of African-American patients with mycosis fungoides: an analysis of the SEER dataset, 1988 to 2008.
abstract: BACKGROUND
  The aims of this study were: (1) to determine whether AA patients with MF have a worse prognosis despite accounting for varying clinical factors at presentation, and (2) to assess whether a racial disparity exists regarding utilization of radiation therapy (RT) as an initial treatment modality.
  
  
  METHODS
  The SEER 1988-2008 public use database was investigated. Univariate and multivariate analysis was used to assess for factors significantly associated with disease-specific survival (DSS), overall survival (OS), and RT utilization survival.
  
  
  RESULTS
  A total of 4892 patients with MF were identified with a median follow-up of 58 months. On multivariate analysis including tumor registry, age, sex, marital status, and tumor stage, AA race was significantly correlated with a worse OS (hazard ratio [HR], 1.58; P < .001) and DSS (HR, 1.78; P < .001). With regard to RT utilization, more advanced age (odds ratio [OR], 1.005; P < .001) and higher stage (OR, 3.03; P < .001) were associated with a higher likelihood of receiving RT, whereas female sex (OR, 0.81; P = .03) was associated with a lower likelihood of receiving RT. AA race was not significantly associated with RT utilization (P = .58).
  
  
  CONCLUSIONS
  AA race was associated with poorer survival despite accounting for demographic factors and tumor stage. Differences in RT utilization according to AA race were not found, however RT was less utilized for female patients. The etiology of this poorer prognosis is unclear and might be related to access to medical care, socioeconomic factors, or undetermined biological differences.
authors: Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.
authors: Sameer K
authors: SK
authors: Nath
authors: Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT.
authors: James B
authors: JB
authors: Yu
authors: Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT. Electronic address: Lynn.wilson@yale.edu.
authors: Lynn D
authors: LD
authors: Wilson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality / Q000532:radiotherapy; D011379:Prognosis; D011878:Radiotherapy / Q000706:statistics & numerical data; D018426:SEER Program / Q000706:statistics & numerical data; D012737:Sex Factors; D012878:Skin Neoplasms / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality / Q000532:radiotherapy; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Cutaneous; Prognosis; Race; Radiation utilization; Survival