Association Between African American Race and Outcomes in Patients With Nonmetastatic Triple-Negative Breast Cancer: A Retrospective Analysis by Using Results From the Georgia Cancer Specialist Database
Association Between African American Race and Outcomes in Patients With Nonmetastatic Triple-Negative Breast Cancer: A Retrospective Analysis by Using Results From the Georgia Cancer Specialist Database
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DOI：
10.1016/j.clbc.2012.04.007
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发表时间：
2012-08-01
影响因子：
3.1
通讯作者：
Szabo, Stephen
中科院分区：
文献类型：
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作者：
Christiansen, Neal;Chen, Lei;Szabo, Stephen
通过使用来自格鲁吉亚癌症专家数据库的记录，我们评估了非洲裔美国人种族对接受辅助化疗的三阴性乳腺癌患者的疾病复发和生存的影响，我们发现，在209名患者中，非洲裔美国人患者的5年复发率较高（42.5% vs. 7.0%; P = .0005）和较低的5年无病生存率（45.2% vs. 79.7%; P = 0.0005）与其他患者相比。本研究的目的是在现实世界背景下评估，在接受辅助化疗的非转移性三阴性乳腺癌（TNBC）患者中，种族对疾病复发和生存的影响。患者与方法：该研究从2003-2008年格鲁吉亚癌症专家数据库中选择了接受过辅助化疗的I-III期确诊TNBC患者。这些患者从最初诊断到死亡、癌症复发或失访进行随访。主要结局是无病生存期（DFS）。Kaplan-Meier曲线比较了非洲裔美国人和非非洲裔美国人组之间的DFS和复发。通过多变量考克斯模型，通过调整年龄、合并症、体重指数（BMI）、吸烟状况、初始TNBC分期、手术和放射治疗，进一步检查非裔美国人身份的影响。结果：在209例TNBC患者中，89例（42.6%）为非洲裔美国人。两组（非裔美国人vs.非裔美国人）在诊断时的平均年龄（53.2 vs. 54.4岁; P = 0.487）以及手术和放疗率（分别为98.9% vs. 100%; P = 0.244; 68.5% vs. 62.5%; P = 0.365）方面相似。与非非洲裔美国人相比，非洲裔美国人患者的BMI更高（30.4 vs. 28.6 kg/m2; P = 0.0477），并且在I期诊断的可能性更低（31.5% vs. 51.7%; P = 0.0107）。与非非洲裔美国人患者相比，非洲裔美国人患者的5年DFS率较低（45.2% vs. 79.7%; P = .0005），5年复发率较高（42.5% vs. 7.0%; P = .0005）。结论：在接受辅助化疗的TNBC患者中，非裔美国人与更差的结局相关，无论就诊时的晚期或BMI较高。
By using records from the Georgia Cancer Specialist Database, we evaluated the impact of African American race on disease recurrence and survival in patients with triple-negative breast cancer who were treated with adjuvant chemotherapy, and we found that, among 209 patients, African American patients had a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) and a lower 5-year disease-free survival (45.2% vs. 79.7%; P = .0005) rate compared with other patients.Introduction: The objective of this study was to evaluate, in a real-world context, the impact of race on disease recurrence and survival in patients with nonmetastatic triple-negative breast cancer (TNBC) treated with adjuvant chemotherapy. Patients and Methods: The study selected patients from the 2003-2008 Georgia Cancer Specialist Database with stage I-Ill confirmed TNBC who had received adjuvant chemotherapy. These patients were followed-up from initial diagnosis to death, cancer recurrence, or loss to follow-up. The primary outcome was disease-free survival (DFS). Kaplan-Meier curves compared DFS and recurrence between African American and non-African American groups. The impact of African American status was examined further through multivariate Cox models by adjusting for age, comorbidity, body mass index (BMI), smoking status, initial TNBC stage, surgery, and radiation therapy. Results: Among 209 patients with TNBC, 89 (42.6%) were African American. The 2 groups (African American vs. non-African American) were similar in mean age at diagnosis (53.2 vs. 54.4 years; P = .487) and with surgery and radiation rates (98.9% vs. 100%; P = .244; 68.5% vs. 62.5%; P = .365, respectively). Compared with non-African Americans, African American patients had a higher BMI (30.4 vs. 28.6 kg/m(2); P = .0477) and were less likely to be diagnosed at stage I (31.5% vs. 51.7%; P = .0107). The African American patients had a lower 5-year DFS rate (45.2% vs. 79.7%; P = .0005) and a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) compared with the non-African American patients. Conclusions: Among patients with TNBC treated with adjuvant chemotherapy, African American race was associated with a worse outcome irrespective of later stage at presentation or higher BMI.