Decoding disparities: A SEER analysis of treatment patterns and timelines for orbital embryonal rhabdomyosarcoma across race, ethnicity, age, and geography (2000–2021).

e13795 Background: Orbital embryonal rhabdomyosarcoma (OER) is a rare skeletal muscle cancer in children. While studies have examined OER treatment prognoses, disparities in treatment access by geography, race/ethnicity, and age remain unexplored. The potential for treatment delays across these variables has not been assessed. This study analyzes whether age, race/ethnicity, and geography are associated with disparities in initiating treatment and accessing treatment options. Methods: Surveillance Epidemiology and End Results (SEER) identified 119 OER patients from 2000 - 2021 with the ICD-O-3 morphologic code 8910/3 and by choosing ‘Eye and Orbit’ cases. Incomplete cases and patients older than 18 were excluded. Variables obtained include race/ethnicity (Non-Hispanic White, Non-White), income, sex, age, and county type (metropolitan, nonmetropolitan). Chi-square tests, odds ratios (ORs), and regression assessed treatment options (surgery, radiation, chemotherapy) provided. ANOVA compared treatment times across age, race/ethnicity, and geography. Multiple linear regression evaluated the effect of all variables on treatment time. Results: Significant differences in radiation therapy exist across race/ethnicity (p = 0.023) and age (p = 0.026). Non-White patients were less likely to receive radiation therapy (OR: 0.223, 95% CI: 0.056 - 0.891), and binary logistic regression confirmed race/ethnicity as a predictor of radiation therapy (p = 0.023). A geographical disparity in chemotherapy access was found (p = 0.020), with metropolitan patients more likely to receive chemotherapy (OR: 7.333, 95% CI: 1.081 - 49.766). ANOVA revealed differences in mean treatment time across age groups, race/ethnicity, and geography. Multiple linear regression identified age as a predictor of treatment time (p = 0.017). Conclusions: This study highlights disparities in access to chemotherapy and radiation therapy across geography and race/ethnicity, respectively. Differences in age group access to radiation may reflect clinical guidelines cautioning its use in newborns due to the risk of compromising developing facial bones. While minor differences in mean treatment times were observed, high variance limits the findings’ reliability. The small sample size of the study introduces variability and underscores the need for additional research on OER treatments. Multiple linear regression analysis of treatment time across demographic and geographic variables (2000 – 2021). ​ Significance (p-values)​ Race/Ethnicity​ p = 0.202​ Sex​ p = 0.814​ Age at Diagnosis​ p = 0.017​ Geography ​ p = 0.532​ Income ​(<$60,000 vs. >$60,000)​ p = 0.822​