Impact of race on care, readmissions, and survival for patients with glioblastoma: an analysis of the National Cancer Database.
Impact of race on care, readmissions, and survival for patients with glioblastoma: an analysis of the National Cancer Database.
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DOI：
10.1093/noajnl/vdab040
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Barnholtz-Sloan JS
中科院分区：
文献类型：
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作者：
Hodges TR;Labak CM;Mahajan UV;Wright CH;Wright J;Cioffi G;Gittleman H;Herring EZ;Zhou X;Duncan K;Kruchko C;Sloan AE;Barnholtz-Sloan JS
本研究的目的是通过查询美国国家癌症数据库（NCDB），探索可能与胶质母细胞瘤患者生存率相关的种族/民族因素。
查询了2004年至2014年间被诊断为胶质母细胞瘤的NCDB患者数据。患者人口统计学变量包括诊断时年龄、性别、种族、民族、查尔森 - 迪奥评分、保险状况以及邮政编码所对应的农村/城市/大都市位置。治疗变量包括手术治疗、切除范围、化疗、放疗、放疗类型以及治疗机构类型。结果包括30天再入院率、30天和90天死亡率以及总生存率。进行了多变量考克斯回归分析以评估与种族和总生存率相关的变量。
共确定了103652名胶质母细胞瘤患者。按种族分层时，接受手术的患者比例以及接受放疗的患者比例存在差异（P <.001）。非西班牙裔黑人在30天内非计划再入院率最高（7.6%）（优势比[OR]：与非西班牙裔白人相比为1.39，P <.001）。与其他种族相比，非西班牙裔亚洲人30天（3.2%）和90天死亡率（9.8%）最低（OR：与非西班牙裔白人相比为0.52，P =.031）。与非西班牙裔白人相比，我们发现非西班牙裔黑人（风险比[HR]：0.88，P <.001）、非西班牙裔亚洲人（HR：0.72，P <.001）和西班牙裔（HR：0.69，P <.001）的总生存期更长。
不同种族之间在治疗和结果方面存在差异。需要进一步的研究来阐明这些与种族相关差异的病因，并改善所有患者的治疗结果。
The objective of this study was to explore racial/ethnic factors that may be associated with survival in patients with glioblastoma by querying the National Cancer Database (NCDB). The NCDB was queried for patients diagnosed with glioblastoma between 2004 and 2014. Patient demographic variables included age at diagnosis, sex, race, ethnicity, Charlson–Deyo score, insurance status, and rural/urban/metropolitan location of zip code. Treatment variables included surgical treatment, extent of resection, chemotherapy, radiation therapy, type of radiation, and treatment facility type. Outcomes included 30-day readmission, 30- and 90-day mortality, and overall survival. Multivariable Cox regression analyses were performed to evaluate variables associated with race and overall survival. A total of 103 652 glioblastoma patients were identified. There was a difference in the proportion of patients for whom surgery was performed, as well as the proportion receiving radiation, when stratified by race (P < .001). Black non-Hispanics had the highest rates of unplanned readmission (7.6%) within 30 days (odds ratio [OR]: 1.39 compared to White non-Hispanics, P < .001). Asian non-Hispanics had the lowest 30- (3.2%) and 90-day mortality (9.8%) when compared to other races (OR: 0.52 compared to White non-Hispanics, P = .031). Compared to White non-Hispanics, we found Black non-Hispanics (hazard ratio [HR]: 0.88, P < .001), Asian non-Hispanics (HR: 0.72, P < .001), and Hispanics (HR: 0.69, P < .001) had longer overall survival. Differences in treatment and outcomes exist between races. Further studies are needed to elucidate the etiology of these race-related disparities and to improve outcomes for all patients.