Background
This study investigates the effects of patient characteristics on overall survival in Sezary Syndrome (SS), addressing a gap in the current literature. SS is a rare and aggressive form of cutaneous T-cell lymphoma (CTCL). SS is presumed to be related to service exposure, and veterans have a 6-8 times higher incidence of CTCL than the general population. A study investigating the socio-demographic factors at diagnosis on overall survival in SS has yet to be done.
Methods
This is a retrospective study of patients diagnosed with SS (ICD- 9701/3) between 2004 and 2020 in the National Cancer Database (NCDB), highlighting patient demographics on overall survival in SS (N = 809). Exclusion criteria included missing data. Descriptive statistics were collected for all patients with SS. Overall survival was determined via KaplanMeier test. Multivariate analysis via Cox regression was performed to determine factors leading to decreased survival in SS. All statistical tests were evaluated for a significance of P < 0.05.
Results
Of 809 patients with SS, the majority were White (77.3%), male (57.8%), and had an average age at diagnosis of 66.9 years (SD=13.0). Age at diagnosis was associated with decreased overall survival (HR 0.028; 95% CI, 1.016 – 1.042, P< 0.05). Patients with SS treated at nonacademic facilities had a HR of 0.41 (95% CI, 1.171 – 1.932, P< 0.05) compared to academic facilities. Those with private insurance had improved survival with a HR of -0.83 [95% CI, (-0.241) - (-0.781), P< 0.05] compared to those who were non-insured. The average survival time for patients with SS was found to be 73.1 months. The average survival time for patients treated at academic facilities was 8.8 months longer than those treated at nonacademic facilities (75.0 vs 66.2 months, P< 0.05). Patients with private insurance had higher overall survival compared to government-insured and non-insured patients (100.4 versus 56.9 and 54.2 months, respectively). Age, facility type, and primary payor are significant factors that affect survival in SS. Further studies should address the influence of these factors on treatments received by SS patients to decrease disparity related to care.
