Impact of demographics and social vulnerability on outcomes in pediatric medullary thyroid cancer.

Objective: To evaluate the impact of social vulnerability and social determinants of health on outcomes in pediatric medullary thyroid cancer.

Methods: A SEER database review looking at cases of pediatric medullary thyroid cancer from 1975 to 2016 was conducted and analyzed including data from the American Community Survey.

Results: A total of 174 patients were included in analysis. Five-year overall survival was 97.7 % and the disease specific survival (DSS) was 98.3 %. On univariate analysis, male sex was associated with worsened overall survival (HR = 4.2, CI 1.1-15.5, p < 0.05) but did not reach statistical significance on multivariate analysis. Asian or Pacific Islander race was associated with worsened overall survival on both univariate and multivariate analysis (HR = 5.5, CI 1.4-22.2, p < 0.05). Presenting with localized disease without nodal or distant metastasis was found to be a protective factor (HR = 0.2, CI 0.05-0.53, p < 0.01).

Conclusion: Asian American/Pacific Islander patients and male patients may have poorer survival in pediatric medullary thyroid cancer. More research should be completed to better understand underlying factors.