QS8. High State-Level Social Vulnerability is Associated with Decreased Receipt of CRS/HIPEC in Non-White Appendiceal Adenocarcinoma Patients

Thursday, March 5, 2026

10:19 AM - 10:23 AM MST

Location: Immuno-Oncology HUB Zone

Co-Author(s)

Rachyl M. Shanker, MD (she/her/hers)

Research Fellow
National Institutes of Health
Washington, District of Columbia, United States
NR

Nicole Russell, BS

TCU School of Medicine
Fort Worth, Texas, United States
MO

Michael P. O'Leary, MD

Assistant Professor of Surgery
University of California, Irvine
Orange, California, United States
Joal D. Beane, MD

Assistant Professor
Department of Surgery, The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
Alex C. Kim, MD, PhD (he/him/his)

Surgical Oncology
UT Southwestern
Dallas, Texas, United States
Oliver S. Eng, MD (he/him/his)

Associate Professor of Surgery
University of California, Irvine
Orange, California, United States

Primary Presenter(s)

Tracey Pu, MD

Resident
University of Alabama - Birmingham
Birmingham, Alabama, United States

Introduction: Disparities in access to cancer treatment persist, often exacerbated by socioeconomic factors. Due to the rarity of appendiceal adenocarcinoma (AA), treatments such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are not widely available. Our study aimed to examine if minoritized patient populations residing in resource-low states experienced differences in receipt of treatment for AA with peritoneal carcinomatosis (PC).

Methods: AA/PC patients from 2010-2020 were analyzed in the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized as White versus Non-White (Non-Hispanic (NH) Black, NH Asian/Pacific Islander, and Hispanic patients). Aggregated state level population-weighted median percentile rankings were calculated for Social Vulnerability Index (SVI) for SEER U.S. counties. Scores were stratified into tertiles, where the third tertile (TR3) represents the most vulnerable.

Results:

1195 AA/PC patients were identified. 775 (59.3%) were female, and 67.9% were White. Non-White AA/PC patients were less likely to receive chemotherapy compared to White patients (68.6% vs. 74.1%, p=0.04) and were also less likely to receive CRS/HIPEC (11.0% vs. 17.7%, p=0.002). On subgroup analysis, Non-White patients residing in the most vulnerable SVI Tertile (T3) were less likely to receive any chemotherapy (65.6% vs. 75.0%, p=0.03) or CRS/HIPEC (13.7% vs. 23.1%, p=0.01), while there was no difference in less vulnerable SVI tertiles (all p >0.05).

Conclusions: Non-White patients were less likely to receive CRS/HIPEC in the highest vulnerability tertile compared to White patients. Further investigation is warranted to guide state-level public health policy to increase treatment access for minoritized populations residing in vulnerable areas.

Learning Objectives:

To analyze rates of receipt of treatment of vulnerable populations of patients with appendiceal adenocarcinoma.
To determine how state-level social vulnerability index affects distribution of cancer care for patients with appendiceal cancer.