Prognostic and demographic patterns in serous tubal intraepithelial carcinoma: A National Cancer Database study

To characterize demographic, clinical, and treatment patterns in patients diagnosed with serous tubal intraepithelial carcinoma (STIC) and assess overall survival (OS) differences between first primary (FP-STIC) and second or greater primary STIC (SP-STIC).

Patients with a diagnosis of STIC from 2004 to 2017 were identified in the National Cancer Database. Demographic and treatment characteristics were compared between FP-STIC and SP-STIC groups. Univariable Cox regression was used to evaluate factors associated with OS, stratified by cancer sequence.

Among 1071 patients with STIC, 444 (41.5 %) had FP-STIC and 627 (58.5 %) had SP-STIC. FP-STIC was more common in younger, privately insured patients, and those treated in the South, whereas SP-STIC occurred more frequently in older, non-White patients, those with more comorbidities, Medicare insurance, and treatment at academic centers in the Northeast. Surgical staging was more common in SP-STIC (89.6 % vs. 80.4 %, p < 0.0001). In multivariable analysis, age ≥ 70 years was independently associated with worse OS (HR 11.44, 95 % CI 5.94-22.01), and age-related survival disparities persisted across both FP-STIC and SP-STIC. Black race was also independently associated with worse OS in the overall cohort (HR 2.06, 95 % CI 1.30-3.28), and in patients with SP-STIC.

Older age at diagnosis and Black race are independently associated with worse survival among patients with STIC, but adjuvant chemotherapy and complete staging did not impact survival. These findings highlight the prognostic importance of age, race, and treatment, and underscore the need for prospective studies to inform management strategies for isolated STIC.