Narrowing of the Racial Disparities Gap in Survival of Patients With Mycosis Fungoides: A Longitudinal Analysis of the SEER Database.

Abstract

Background: Mycosis fungoides (MF) is the commonest subtype of cutaneous T-cell lymphoma. In the United States, prior studies reported that African Americans (AA) with MF had poor outcomes. Data characterizing differences in racial disparity outcomes over time are limited.

Patients and methods: We collected data from the United States Surveillance, Epidemiology, and End Results (SEER) database to investigate the survival patterns of patients with MF from 1988 to 2011. Cases were divided into 3 cohorts based on the year of diagnosis. Univariable and multivariable analysis were conducted to assess for factors associated with overall survival (OS).

Results: 2896 cases of MF were detected, with a median follow-up duration of 60 months. The disparity in survival between the years 1988-1995 and 2004-2011 was significant (P = .05). The parameter estimates of the Cox proportional hazards model for the 1988-1995 period (using the 2004-2011 period as a reference) was also significant (P = .024). Patients diagnosed between 1988 and 1995 were 1.4 times more likely to die from the disease than those diagnosed between 2004 and 2011. The survival gap between AA and white patients narrowed in 1996-2003 and 2004-2011 in comparison to 1988-1995. This indicates improvements in the survival of AA patients over time. Conversely, the survival rates of white patients remained relatively stable over time.

Conclusions: Our study demonstrates that AA with MF have reduced survival. Despite the persistent pattern of lower survival across all periods, the gap in survival between white and AA seems to be narrowing over time.