Characterizing Socioeconomic Factors That Influence Treatment Selection in Myxoid Liposarcoma: A Population-Based Study From the Surveillance, Epidemiology, and End Results Database.

Abstract

Introduction: Myxoid liposarcoma (MLS) is the second most common liposarcoma, representing 6% of adult soft-tissue sarcomas. This study examines differences in treatment types and survival outcomes by income and rurality in MLS patients.

Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database for MLS patients from 2000 to 2021. Variables included age, sex, income, and rurality. Treatment types included surgery, chemotherapy, and radiotherapy. Time from diagnosis to treatment was compared by income and rurality. Survival was assessed using the Fine-Gray model.

Results: The cohort included 2544 MLS patients: 55.6% above median income and 91.2% urban. Higher-income patients were more likely to receive radiotherapy (p < 0.001), while urban patients were more likely to undergo surgery (p < 0.001). For Grades 2 and 3 tumors, high-income patients were more likely to undergo surgery (odds ratio [OR] = 2.35; 95% confidence interval [95% CI]: 1.16-4.74, p = 0.017) and radiotherapy (OR = 1.42, 95% CI: 1.09-1.87, p = 0.010). Urban patients were also more likely to undergo surgery (OR = 2.85, 95% CI: 1.26-6.48, p = 0.012).

Conclusions: In this MLS cohort, patients with higher incomes were more likely to receive radiotherapy and surgical resection for Grades 2 and 3 tumors. These findings highlight the need for risk-adapted treatment approaches to standardize interventions across socioeconomic groups.