Low socioeconomic status is a poor prognostic factor for survival in stage I nonsmall cell lung cancer and is independent of surgical treatment, race, and marital status
Low socioeconomic status is a poor prognostic factor for survival in stage I nonsmall cell lung cancer and is independent of surgical treatment, race, and marital status
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DOI：
10.1002/cncr.23397
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发表时间：
2008-05-01
期刊：
影响因子：
6.2
通讯作者：
Anton-Culver, Hoda
中科院分区：
文献类型：
--
作者：
Ou, S. -H. Ignatius;Zell, Jason A.;Anton-Culver, Hoda
背景少数种族表现出非小细胞肺癌（NSCLC）的生存率低，通常归因于社会经济地位低（SES）。在这项研究中，作者调查了SES在I期NSCLC患者生存差异中的作用。仅对加州癌症登记处（CCR）的数据（1989-2003年）进行病例分析。使用Kaplan-Meier方法进行单变量生存分析。采用考克斯比例风险比进行多变量生存分析。总共分析了19，702例I期NSCLC事件病例。低SES在非洲裔美国人和西班牙裔患者中更常见，与男性、未婚状态、113期疾病、鳞状细胞组织学、低分化肿瘤、手术切除较少和接受的总体治疗较少显著相关。不手术的原因与低社会经济地位和未婚状态密切相关，但与种族无关。在多变量分析中，SES五分位数的每一次增量改善均与死亡风险比（HR）的统计学显著降低相关（第二个SES五分位数[SES 2] vs SES 1：HR，0.91; 95%置信区间[95% CI]，0.85-0.98; SES 3 vs SES 1：HR，0.90; 95% CI，0.84-0.97; SES 4 vs SES 1：HR，0.91; 95% CI，0.84-0.97）。HR，0.83; 95% CI，0.77-0.89; SES 5 vs SES 1：HR，0.78; 95% CI，0.72-0.84; P趋势
BACKGROUND. Racial minorities exhibit poor survival with nonsmall cell lung cancer (NSCLC) that generally is attributed to low socioeconomic status (SES). In this Study, the authors investigated the role of SES in this survival disparity among patients with stage I NSCLC.METHODS. A case-only analysis was performed on California Cancer Registry (CCR) data (1989-2003). Univariate survival analyses were performed using the Kaplan-Meier method. Multivariate survival analyses were performed using Cox proportional hazards ratios.RESULTS. In total, 19,702 incident cases of stage I NSCLC were analyzed. Low SES was identified more commonly in African-American and Hispanic patients and was associated significantly with men, unmarried status, stage 113 disease, squamous cell histology, poorly differentiated tumors, fewer surgical resections performed, and less overall treatment received. Reasons for no surgery were associated strongly with low SES and unmarried status but not with race. In multivariate analysis, each incremental improvement in SES quintile was associated with statistically significant decreases in the hazard ratios (HRs) for death (second SES quintile [SES2] vs SES1: HR, 0.91; 95% confidence interval [95% CI], 0.85-0.98; SES3 vs SES1: HR, 0.90; 95% CI, 0.84-0.97; SES4 vs SES1: HR, 0.83; 95% CI, 0.77-0.89; SES5 vs SES1: HR, 0.78; 95% CI, 0.72-0.84; P-trend