Racial and ethnic variation in presentation and outcomes of high-grade soft tissue sarcoma at a Southeastern United States comprehensive cancer center

High-grade soft tissue sarcoma is rare and associated with poor prognosis. This study examines racial and ethnic variation in presentation and outcomes at a Southeastern US cancer center. Among an institutional cohort of patients seen between January 2016–December 2021, racial and ethnic differences were evaluated using chi-squared tests, Kaplan Meier curves, and Cox proportional hazards models. There were 295 patients (71 % Non-Hispanic White, 24 % Black, 3 % Hispanic White, 2 % Other). Black representation was greater than national cohorts (24 % vs. 12 %). Histological subtype varied by race/ethnicity (p = 0.007). Adjusting for histology and stage, survival was worse for Black vs. White patients (HR 1.71, 95 % CI 1.07–2.76) and those with metastatic disease (5.47, 3.54–8.44). In non-metastatic patients, survival differences for Black vs. White patients were attenuated by receipt of multi-modal treatment (1.53, 0.82–2.88). Observed racial disparities in survival of high-grade sarcoma may be addressed by early, multidisciplinary management. •Black representation in our cohort was greater than national cohorts.•Survival was worse for Black vs. White patients and those with metastatic disease.•In non-metastatic patients, survival differences for Black vs. White patients were attenuated by receipt of multi-modal treatment.