Introduction: Cutaneous T-cell lymphoma (CTCL), including mycosis fungoides (MF) and Sézary syndrome (SS), exhibits survival disparities by race and sex.
Objective: This study examined racial and sex-based survival disparities in MF and SS.
Methods: Using SEER8 database (1975–2021), we identified 5330 MF and 193 SS cases. Kaplan-Meier methods were used to calculate age-adjusted overall survival (OS) and disease-specific survival (DSS), stratified by race (Non-Hispanic White [NHW], Non-Hispanic Black [NHB], Hispanic) and sex.
Results: For MF, NHB peaked at ages 41–60, whereas NHW peaked at 61–70. In SS, NHB was more evenly distributed across ages 31–80, while NHW patients showed highest incidence at ages 71–80.
For MF, 5-year OS was 74.1% (95% CI: 72.5%–75.5%) and DSS 87.2% (95% CI: 85.9%–88.4%). NHW had better 5-year OS and DSS compared to NHB patients (OS: 74.6% [95% CI: 72.8%–76.3%] vs. 61.8% [95% CI: 55.2%–67.7%]; DSS: 86.9% [95% CI: 85.3%-88.3%] vs. 78.9% [95% CI: 71.5%-84.5%]). For SS, NHB males demonstrated the poorest outcomes, with a 5-year OS of 25.9% [95% CI: 3.9%-57%] and DSS of 29.6% (95% CI: 4.3%– 62.5%).
For MF, DSS has steadily improved, particularly after the late 1990s with the introduction of systemic therapies like interferon and bexarotene. For SS, OS and DSS have significantly increased after 2010, likely due to targeted therapies like mogamulizumab.
Conclusions: This study highlights significant racial and sex-based survival disparities in MF and SS. NHB patients with SS, especially males, exhibit worse survival outcomes.
