C77-37 The Impact of Sociodemographic and Clinical Factors on Survival in Insular Thyroid Carcinoma: A Seer Database Analysis

Abstract Rationale Insular thyroid carcinoma (ITC) is a rare, poorly differentiated subtype of thyroid cancer with an aggressive clinical behavior that is intermediate between well-differentiated and anaplastic forms. While prior studies have characterized its clinical course, a significant gap remains in the comprehensive evaluation of sociodemographic factors and their impact on overall survival. This study aims to investigate the association between demographic variables, including marital status and income, alongside established clinical factors, on survival outcomes in a large, population-based cohort of ITC patients. Methods Data for patients diagnosed with ITC from 2000 to 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database using the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) histology code 8337/3. Overall survival was analyzed using Kaplan-Meier curves with log-rank tests for comparisons. 433 patients were included, with a median follow-up of 42. 5 months. Analyzed variables included age at diagnosis, sex, marital status, estimated median household income, SEER historic stage, and primary treatment modality (surgery, radiation, chemotherapy, or no treatment). Results Among 433 patients, 212 deaths occurred. Older age (≥65 years) predicted poorer survival (Hazard Ratio HR 2. 64, 95% CI 1. 99-3. 51), with a median survival of 66 months versus 140 months for patients 65 years (P 0. 0001). Modestly worse survival was observed in single patients (median survival 84 months) compared to married patients (median survival 91 months) (HR 1. 28, 95% CI 0. 97-1. 68; P = 0. 021). High income (120, 000) was associated with significantly improved survival (HR 0. 34, 95% CI 0. 19-0. 61; P = 0. 0013). Predictably, greater disease spread showed worse outcomes (P 0. 0001), with distant spread showing the poorest median survival (32 months), compared to regional (93 months) and localized (173 months) disease. Treatment modality significantly impacted survival (P 0. 0001). Patients receiving surgery (median survival 95 months) or radiation (median survival 93 months) had superior outcomes compared to those receiving chemotherapy (median survival 34 months) or no treatment (median survival 1 month) ; no significant difference was observed between the chemotherapy and no treatment groups. Conclusions This population-based analysis confirms the prognostic significance of age and disease stage in ITC. It additionally identifies marital status and household income as modest but significant demographic factors associated with survival disparities. The markedly inferior survival for patients receiving chemotherapy or no treatment highlights the critical role of surgical intervention and radiation. These findings emphasize the need for aggressive, stage-appropriate initial management and suggest that sociodemographic factors should be considered in patient risk stratification and support. This abstract is funded by: None