(P 259) ASSOCIATION BETWEEN AREA DEPRIVATION INDEX AND INITIAL TREATMENT AMONG PATIENTS WITH DESMOID TUMORS

Objective: Desmoid tumors are rare, locally aggressive tumors with high rates of recurrence. They can cause significant morbidity due to their invasive nature; and while traditionally treated with surgery, they may require multimodal therapy to control. Current guidelines recommend other therapies over surgery as a first approach given the high rates of recurrence. However, patients residing in areas with reduced access to tertiary care centers may be at a disadvantage for consideration of multimodal treatment. The aim of this study was thus to evaluate the association between Area Deprivation Index (ADI) and initial treatment received among patients with newly diagnosed desmoids.

Methods: Patients who were evaluated at The Ohio State University between January 1st, 2010 and January 1st, 2021 for treatment of their desmoid tumors were included in the analysis. Individual addresses of each patient were assessed with the Neighborhood Atlas online tool using U.S. Census Bureau geographies to determine the respective ADI. Associations between ADI and desmoid treatment plans were then analyzed using univariate regression.

Results: Of 151 patients who were treated for their desmoid tumors at The Ohio State University, 33% were male (n=49), 83% were white (n=125), median age was 36 years, and mean tumor size was 7 cm. ADI ranged from 1-99 with a median ADI of 54 for the cohort. 108 patients (71%) underwent surgical resection, 37 patients (25%) were treated with chemotherapy, and 6 (4%) were radiated. Median ADI for patients who underwent surgery was 51.5, 64.5 for patients who received chemotherapy, and 55 for those who had radiation. Patients with higher ADIs were more likely to be treated with chemotherapy compared with surgical resection (p=0.013). There were no differences in age, sex, or tumor size between patients based on ADI.

Conclusion: Among patients with newly diagnosed desmoid tumors, those residing in regions with higher ADIs were more likely to receive chemotherapy as their initial treatment. This may reflect differences in access to resources and follow-up that need to be addressed with future outreach initiatives for disadvantaged regions. Further studies are necessary to better define these treatment differences.