The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma - Results from the National Cancer Data Base
The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma - Results from the National Cancer Data Base
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DOI：
10.1002/cncr.23572
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发表时间：
2008-08-01
期刊：
影响因子：
6.2
通讯作者：
Feig, Barry W.
中科院分区：
文献类型：
--
作者：
Al-Refaie, Waddah B.;Tseng, Jennifer F.;Feig, Barry W.
背景基于区域的研究表明，种族与胃腺癌患者的表现和结局相关。为了在一个大的队列中验证这一观察结果，本报告的作者使用了国家癌症数据库（NCDB）来确定自我报告的种族是否会影响该患者人群的表现和生存率。按种族分析患者人口统计学、肿瘤相关特征和治疗相关特征。使用卡方检验进行单变量分析。采用Kaplan-Meier法分析总的中位生存率和相对生存率。考克斯比例风险模型被用来确定生存结局的预测因子。1995年至2002年，81，095例胃腺癌病例被录入NCDB。有57，943例白色患者（71.5%）、11，094例非洲裔美国人患者（13.7%）、5665例西班牙裔患者（7%）、4736例亚洲/太平洋岛民（API）患者（5.8%）和1657例其他种族患者（2%）。在比较的变量中，根据种族观察到显著差异（所有P <0.01）。在I期和II期疾病患者中，API的5年相对生存率（I期，77.2%; II期，48%）比白人（I期，58.7%; II期，32.8%），非洲裔美国人（I期，55.9%; II期，37.9%）和西班牙裔美国人（I期，60.8%; II期，39.3%）更有利。API的总体中位生存期比其他药物更有利（P < .01）。预后较好的预测因素为亚裔、女性、年轻、早期、低级别、远端肿瘤、多模式治疗和教学医院的护理。种族与胃腺癌患者的临床表现和预后差异相关。APIs比其他种族的患者有更有利的结局。进一步的研究应该针对潜在的生物和社会经济因素来解释这些差异。
BACKGROUND. Regional-based studies have indicated that ethnicity is associated with presentation and outcome in patients with gastric adenocarcinoma. To validate this observation in a large cohort, the authors of this report used the National Cancer Data Base (NCDB) to determine whether self-reported ethnicity influences presentation and survival in this patient population.METHODS. Patient demographics, tumor-related features, and treatment-related features were analyzed by ethnicity. Univariate analyses were performed using the chi-square test. Overall median and relative survival rates were examined by using the Kaplan-Meier method. Cox proportional-hazards models were used to identify the predictors of survival outcomes.RESULTS. Between 1995 and 2002, 81,095 cases of gastric adenocarcinoma were entered into the NCDB. There were 57,943 white patients (71.5%), 11,094 African-American patients (13.7%), 5665 Hispanic patients (7%), 4736 Asian/Pacific Islander (API) patients (5.8%), and 1657 patients of other ethnicities (2%). Significant differences were observed according to ethnicity among the variables that were compared (all P < .01). In patients with stage I and II disease, the 5-year relative survival rates for APIs (stage I, 77.2%; stage II, 48%) were more favorable than for whites (stage I, 58.7%; stage II, 32.8%), African Americans (stage I, 55.9%; stage II, 37.9%), and Hispanics (stage I, 60.8%; stage II, 39.3%). The overall median survival of APIs was more favorable than that of others (P < .01). Predictors of a better outcome were Asian race, female sex, younger age, earlier stage, lower grade, distal tumors, multimodality treatment, and care at a teaching hospital.CONCLUSIONS. Ethnicity was associated with differences in presentation and outcome of patients with gastric adenocarcinoma. APIs had a more favorable outcome than patients of other ethnicities. Further studies should target underlying biologic and socioeconomic factors to explain these differences.