Background: Recent investigations of malignant peripheral nerve sheath tumor (MPNST) survival have reported higher mortality among non-White individuals. However, previous analyses have not examined the impact of socioeconomic status on these observations. This study aims to characterize factors associated with cause-specific MPNST survival, including information related to census-tract level socioeconomic status (CT-SES). Methods: We identified 2370 primary MPNSTs using the SEER 18 (2000-2016) database. We used Cox proportional hazards modeling to estimate the effects of sex, race/ethnicity, CT-SES quintile, metastasis at diagnosis, tumor site, age at diagnosis, and treatment by surgery on survival. Models were fit in both the full population and, separately, stratified by race/ethnicity and age at diagnosis (<40 vs &GreaterEqual 40). Results: In adjusted models, age at diagnosis, CT-SES, and metastasis at diagnosis were associated with mortality. In race/ethnicity stratified analysis, higher CT-SES was found to improve survival only in the White population. Among those diagnosed before age 40, metastasis at diagnosis and American Indian/Alaska Native race/ethnicity were associated with mortality, and both Hispanic ethnicity and Asian/Pacific Islander race were suggestive for increased mortality. Among cases diagnoses at age 40 and above, age at diagnosis, male sex, and CT-SES were associated with mortality. Conclusions: This analysis provides evidence that among pediatric and young adult patients, non-White populations experience inferior survival compared to Whites, independent of CT-SES. Our findings also suggest that the effect of CT-SES on MPNST survival may differ by racial/ethnic group. Impact: These findings suggest that barriers to healthcare for certain racial/ethnic groups extend beyond SES.

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