Abstract 7107: Racial, gender and socioeconomic disparities in survival outcomes of gastrointestinal stromal tumors: a retrospective analysis from 2000 to 2021

Abstract Background: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that originate in the interstitial cells of Cajal or precursor cells within the gastrointestinal (GI) tract, predominantly affecting the stomach and small intestine. GISTs represent the most common type of GI mesenchymal tumors, accounting for approximately 1-3% of all GI tumors. In this study, we explored the effect of gender, race/ethnicity, and socioeconomic factors on survival outcomes among patients with GISTs in the United States. Methods: We extracted data on patients with a histological diagnosis of GISTs from the Surveillance Epidemiology and End Result (SEER) Registry from 2000-2021. The primary outcome of interest was cause-specific survival. According to the International Classification of Disease for Oncology, Third Edition (ICD-O 3) system, the histological code of GISTs is 8936/3. We excluded patients of missing or unknown race, income, location, and patients outside the years of study. Kaplan-Meier methods were used to estimate 5-year survival rates. Cox proportional hazards regression was used for multi-variable modeling of the survival database. The difference between the observed number of events between each group was compared using a log-rank statistical test. Patients were followed up for 5 years, and survival analysis results were censored at this point, with hazard ratios reflecting 5-year overall survival (OS) between groups. Results: 11, 247 patients met the inclusion criteria. The gender split was 5, 719 males (50.9%) and 5, 528 females (49.1%). Based on gender, males as compared to females have significantly worse outcomes hazard ratio was 1.18 (95% CI 1.1-1.26, p<0.001). Races were categorized into non-Hispanic Black (n=2092, 18.6%), Non-Hispanic White (n=6027, 53.6%), non-Hispanic Asian or Pacific Islander (n=1616, 14.4%), Hispanic (n=1490, 13.2%), and Alaskan-Native/American Indian (n=22, 0.2%). Compared to Hispanic patients, White and Black patients had significantly worse outcomes (HR 1.13, 95% CI 1.01-1.26, HR 1.38, 95% CI 1.22-1.56, p=0.028, p<0.001, respectively), with no significant difference in outcome among other races. Compared to patients with distant metastasis (n=2403), patients with localized disease had significantly better outcomes (HR 0.26, 95% CI 0.24-0.28). When household income was categorized above and below $60, 000 per annum, higher household income was also associated with better outcomes (HR 0.86 95% CI 0.78-0.94, p<0.001). Conclusions: Gender, race/ethnicity, and income disparities all played a significant role in cause-specific survival in patients with GISTs, with improved survival in females, higher household income (>$60K), and Hispanic patients as compared to Whites and Blacks. More efforts and research are needed to elucidate the root cause and mitigate these survival disparities. Citation Format: Asfand Yar Cheema, Oboseh J. Ogedegbe, Muhammad Faisal Aslam, Serhan Unlu, Mishaal Munir, Kai He, Utkarsh Acharya. Racial, gender and socioeconomic disparities in survival outcomes of gastrointestinal stromal tumors: a retrospective analysis from 2000 to 2021 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7107.