EP715 - Socioeconomic and Demographic Disparities in Chemotherapy Use After Metastasectomy for Stage IV Rectal Cancer

Monday, May 11, 2026

8:32 AM - 8:37 AM ET

ePoster Presenter(s)

AH

Alana Hagley, n/a

PGY3 Surgery Resident
Medstar Georgetown/Washington Hospital Center
Washington, District of Columbia, United States

Disclosure information not submitted.

Author(s)

Jacob M. Broome, MD

General Surgery Resident
MedStar Georgetown-Washington Hospital Center
Georgetown Washington Hospital Center
Washington, DC, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SG

Shadin Ghabra, MD

Resident
Medstar Georgetown University Hospital
Medstar Georgetown University Hospital
Arlington, VA, United States

Disclosure information not submitted.
Jacob Neary, MS, MD

Fellow
MedStar Washington Hospital Center
Medstar Washington Hospital Center-Georgetown University Hospital
Washington, DC, United States

Disclosure information not submitted.
Mariana Tumminello, MD

Resident Physician
Medstar Georgetown Washington Hospital Center
MedStar Georgetown/Washington Hospital Center
Washington, DC, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SB

Sara Berkey, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
ZS

Zhifei (Jeff) Sun, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

Disclosure information not submitted.
Preetha Ali, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

Disclosure information not submitted.
AF

Anne Fabrizio, MD

Colon and Rectal Surgeon
Medstar Georgetown University Hospital
Washington, District of Columbia, United States

Disclosure information not submitted.

Senior Author(s)

BB

Brian Bello, MD

Regional Chief of Colorectal Surgery
MedStar Health

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Jacob M. Broome, MD: This individual has no financial relationships with ineligible companies.

Mariana Tumminello, MD: This individual has no financial relationships with ineligible companies.

Sara Berkey, MD: This individual has no financial relationships with ineligible companies.

Purpose/Background: Literature is available for stage IV colorectal cancer undergoing metastasectomy in evaluating race, age, and socioeconomic status. However, this is limited for stage IV rectal cancer. Herin, we aim to evaluate different disparities and receipt of chemotherapy in patients with stage IV rectal cancer.

Methods/Interventions: A retrospective review of the National Cancer Database (NCDB) was conducted from 2004-2021. Patients with Stage IV rectal cancer who underwent a metastasectomy were included in the study. The primary outcome of the study was receipt of chemotherapy. Multivariate regression was used to determine the impact of age, gender, race, insurance status, education, and socioeconomic status.

Results/Outcomes: A total of 5,449 patients were included for analysis. The population primarily identified as male (57.6%) and white (87.2%%) with a median (IQR) age of 57 (49-65) years. The most common histopathology was (60.6%) moderately differentiated. Chemotherapy was administered 88.7%.

On multivariable analysis, younger age was significantly associated with higher odds of receiving chemotherapy following metastasectomy (OR = 0.93 per year increase; 95% CI 0.92-0.94; p < 0.001). Male patients were more likely to receive chemotherapy compared to females (OR = 1.33; 95% CI 1.10-1.61; p = 0.004). Compared with White patients, Black patients had significantly lower odds of receiving chemotherapy (OR = 0.50; 95% CI 0.36-0.69; p < 0.001), while the difference for other racial groups was not statistically significant. Patients with private insurance (OR = 2.31; 95% CI 1.48-3.62; p < 0.001) and Medicare (OR = 1.79; 95% CI 1.11-2.88; p = 0.017) were more likely to receive chemotherapy compared to uninsured patients. Treatment at academic/research programs was also associated with higher odds of chemotherapy administration (OR = 1.70; 95% CI 1.11-2.59; p = 0.014). Finally, patients residing in areas with lower percentages of adults without a high school diploma were more likely to receive chemotherapy (OR = 1.60-1.75; p ≤ 0.001).

Conclusion/Discussion: Among patients with stage IV rectal cancer undergoing metastasectomy, receipt of postoperative chemotherapy was influenced by demographic, socioeconomic, and institutional factors. Younger age, male sex, private or Medicare insurance, and treatment at academic or research centers were associated with higher likelihood of receiving chemotherapy, whereas Black race and residence in areas with lower educational attainment were associated with lower likelihood. These findings highlight persistent disparities in the delivery of systemic therapy and emphasize the need for strategies to promote equitable access to comprehensive cancer care for patients with advanced rectal cancer.