Abstract 6746: Academic facility is associated with improved survival in patients with leiomyosarcoma: a national cancer database analysis
Authors: Stanley Steven , Braaten Marco , Silberstein Peter 
Published: April 2023

Abstract
Background: Leiomyosarcoma is a malignant sarcoma of smooth muscle that comprises 10-20% of all sarcomas with a predilection to the uterus and peritoneum. 1 Prior studies have shown treatment at Academic facilities is associated with improved outcomes in cancer treatment.2 The objective of this study was to investigate the effect of treatment at an Academic facility on overall survival in patients with leiomyosarcoma.
Methods: The National Cancer Database (NCDB) was used to identify patients with leiomyosarcoma from 2004-2019 using the ICD-O-3 histology codes 8900 and 8901. Facility types used were assigned by the Commission on Cancer Accreditation program. Categorical Academic and Non-Academic variables were created. Data was analyzed using SPSS with a statistical significance of α = 0.05.
Results: Of the 7950 patients included in this study, 3122 were treated at Academic facilities with a median survival of 77.6 months compared to 61.0 months for patients treated at a Non-Academic facility, which was statistically significant on long-rank testing (p&lt;0.001). Compared to patients treated at Non-Academic facilities, patients at Academic facilities experienced delay in the average surgical initiation time (p&lt;0.001), however, they were more likely to have surgery (88.1% vs. 74.1%; p&lt;0.001), have no residual tumor margins on resection, (63.4% vs. 53.3%; p&lt;0.001) and receive adjuvant chemotherapy (15.2% vs. 12.4%; p&lt;0.001). Academic facility patients also had a younger mean age and were more likely to come from highest median income quartile (36.9% vs. 33.2; p&lt;0.001).
Conclusions: Patients with leiomyosarcoma treated at Academic facilities experienced improved survival compared with patients with the same disease treated at Non-Academic facilities. These patients experienced higher rates of surgery, adjuvant therapy and wider excisional margins. It is possible that treatment discrepancies and/or differences in surgical technique vary by facility type and contribute to the observed differences in survival.
Citations-1. Devaud, N., et al. (2022). Leiomyosarcoma: Current Clinical Management and Future Horizons. Surgical oncology clinics of North America, 31(3), 527-546. https://doi.org/10.1016/j.soc.2022.03.0112. Gootee, J., Silberstein, P., et al. (2020). Important prognostic factors in leiomyosarcoma survival: a National Cancer Database (NCDB) analysis. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 22(6), 860-869. https://doi.org/10.1007/s12094-019-02196-7
Citation Format: Steven Stanley, Marco Braaten, Peter Silberstein. Academic facility is associated with improved survival in patients with leiomyosarcoma: a national cancer database analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6746.