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Purpose: To assess if the time interval between concurrent chemo radiotherapy [conc ChemoRT] followed by brachytherapy [B] determines the clinical outcomes in cervical cancer patients (FIGO stage IB2 – IVA) among a predominantly African- American population in a state university medical center. Methods: A retrospective analysis of 147 cervical cancer patients diagnosed with stage IB2- IVA treated with conc ChemoRT followed by B at various time intervals between 2005 and 2018 was performed. Survival analysis with several treatment [TX] duration interval parameters (pre 2010 and post 2010 to evaluate the significant organizational advancements); conc ChemoRT and B completed ≤ 60 days and > 60 days per American College of Surgeons cervical cancer surveillance measure; and TX intervals 6 to 10 weeks were evaluated. The overall survival [OS], local control [LC] and distant control [DC] were estimated by using Kaplan- Meier method. Uni, bi and multi- variable Cox hazard regression analyses were used to compare the risk of death among cervical cancer patients with different TX intervals. The SPSS v.24.0 was used for statistical analyses. Results: The 147 cervical cancer patients (median age, 55 y; range 28-83 y) had a median follow-up of 32 months (range 0 to 164 months). Our patient cohort included 34% patients treated pre 2010 and 66% post 2010; 42.2% ≤60 days and 57.8% > 60 days; 53.1% ≤ 6 to 8 weeks, 12.2% ≤ 8 to 10 weeks and 34.7% d>10 weeks. The patients diagnosed and treated post 2010 had better 5-year OS rates (65% vs. 32%) compared to pre 2010; p=0.000; patients treated ≤ 60 days had better 5-year OS rates (59.3% vs. 40.3%) to > 60 days; p=0.094; patients treated ≤ 6 to 8 weeks had better 5-year OS rates (56.1% vs. 53.1% and 34.3%) compared to ≤ 8 to 10 weeks and > 10 weeks; p=0.188 respectively. The 5-y OS rates for FIGO stages were IB2 (65.8%); IIA (62.5%); IIB (40.4%); IIIA (50%); IIIB (42.4%); and IVA (25.2%); p=0.508. There was no trend for improved LC (p=0.331; p=0.962; p=0.616) and DC (p= 0.284; p=0.596; p=0.606) observed among patients with different TX intervals. In the bi-variate analysis for TX year group, after adjusting for age, race, insurance, income level, distance travelled, tobacco exposure, alcohol history, and tumor stage, BMI-lower had twice the risk of death (hazard ratio [HR], 2.74; 95% CI, 1.34-5.59; p= 0.005). For patients treated ≤ 60 days, their insurance-private had a 63% reduction (HR, 0.37; 95% CI, 0.15-0.90; p=0.029), and for the weekly TX group by the multivariate analysis, insurance-private showed a 76% reduction in the risk of death (HR, 0.35; 95% CI, 0.14-0.87; p=0.024). Conclusion: Our analysis suggests better OS among patients diagnosed and treated post 2010; ≤ 60 days duration; and ≤ 6 to 8 weeks with a shorter interval between conc ChemoRT and B to be superior to that of the patients undergoing longer TX’s. Citation Format: Mary R. Nittala, Satyaseelan Packianathan, Eswar K. Mundra, Maurice L. King, Shivanthidevi Gandhi, Robert M. Albright, Maria L. Smith, William C. Woods, Toms V. Thomas, Mildred Ridgway, Srinivasan Vijayakumar. Improved clinical outcomes with shorter intervals between concurrent chemoradiation and brachytherapy in FIGO IB2-IVA cervical cancer patients among a predominantly African-American population [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-230.

Introduction: The purpose of this study is to determine the likelihood of racial disparities between African American and Caucasian patients treated with hypopharyngeal carcinoma at a tertiary care institution over the last 25 years. Methods: HIPPA-compliant, IRB-approved retrospective analysis of patients with squamous cell carcinoma of the hypopharynx treated at our institution between January 1994 and December 2018 was performed. The data regarding the demographics, stage, treatment and follow up were collected. Outcomes including median survival and overall survival were evaluated using the Kaplan Meier method. All analyses were performed using SPSS version 24. Results: We evaluated 144 hypopharyngeal carcinoma patients who were treated during the time period. Our patient cohort consisted of 61.8% African Americans and 35.4% Caucasians (P= 0.538). Overall, 96% of patients presented with advanced stage disease (stages III & IV), and only 4% of patients presented with early stage disease (Stages I & II). There was no significant difference between African American and Caucasians who presented with advanced disease (96.6 % vs 94.1%). Among our patient cohort, 15.3% of patients didn’t receive any treatments, 51.4%, 22.9% and 10.4% of patients underwent definitive chemoradiotherapy, definitive surgery, and palliative chemotherapy respectively. There were no significant differences in each treatment group between the two races. The median follow up of the entire cohort was 13 months. There was no significant difference in the median survival of African American and Caucasian patients (16 months vs 15 months, p=0.917). In addition, there was no significant difference in the overall survival between African American and Caucasian patients at 3 years (27.2% vs 36.3%, p=0.917) or at 5 years (20.4% vs 16.7 %, p= 0.917). Conclusions: Retrospective review of the patients with hypopharyngeal cancer treated at our institution over the last 25 years did not reveal a significant racial disparity in regards to stage at presentation or prognosis. This study demonstrates that if patients have equal access to the care, they are likely to have similar prognosis despite racial differences. Further studies are warranted to validate this hypothesis. At the meantime, efforts should be focused on improving the access to medical care for the underserved population. Citation Format: Toms Vengaloor Thomas, Mary R Nittala, Teessa Perekattu Kuruvilla, Anu Abraham, Eldrin Bhanat, Satyaseelan Packianathan, Madhava Kanakamedala, Srinivasan Vijayakumar. Is there a racial disparity in the prognosis of hypopharyngeal carcinoma? 25-year experience from a tertiary care medical center in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D127.

Introduction: The purpose of this study was to evaluate the racial disparities among patients with carcinoma of cervix treated at a tertiary care institution. Methods: An IRB-approved and HIPPA-compliant retrospective analysis of patients with carcinoma of cervix was performed. All patients were treated in the department of Radiation Oncology at our institution between 2010 and 2018. Data regarding demographics, stage, treatment administered, and follow up were collected. Patient outcomes including median survival and overall survival were evaluated using the Kaplan Meier method. All analyses were performed using SPSS v. 24. Results: One hundred sixty-five patients with carcinoma of the cervix were treated between January 2010 and December 2018. We had significantly higher proportion of African American (AA) as compared to Caucasian Americans (CA) patients (59.4 % vs 36.4 %; p=0.03). There was a significant difference in stage at the time of presentation between African Americans and Caucasian Americans in that a higher number of CA patients presented with locally advanced disease, (FIGO Stages IB2 to IVA) as compared to AA (86.7 vs 78.6 %; p=0.000). Unfortunately, a higher number of African Americans presented with metastatic disease at diagnosis 13.3 % vs 8.3 % (p=0.000), as compared to Caucasian Americans. In regard to treatment, 157 (95.2 %) underwent definitive chemoradiotherapy while 3 (1.8 %) had definitive surgery, followed by adjuvant radiation or chemoradiation depending on the risk factors. The treatment details of 5 patients were not available. The median follow up and the median survival of the entire cohort was 16 months and 79 months, respectively. In our cohort, there was no significant difference in overall survival between AA and CA patients at 3 years (80 % vs 68 %; p=0.883) or at 5 years (77 % vs 68 %; p=0.883). As expected, patients with locally advanced disease showed a significantly improved median survival of 79 months as compared to 11 months for those with metastatic disease at their presentation (p=0.000). Conclusions: Retrospective review of the patients with carcinoma of the cervix treated at our institution over the last 8 years revealed a significant racial disparity in that more AA women presented with metastatic disease. However, our analysis did not identify any racial disparity in the prognosis of the whole cohort. Citation Format: Toms Vengaloor Thomas, Eldrin Bhanat, Shivanthidevi Gandhi, Teessa Perekattu Kuruvilla, Anu Abraham, Mildred Ridgway, Satyaseelan Packianathan, Srinivasan Vijayakumar. Racial disparities among patients with carcinoma of the cervix [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D126.