Racial Disparities in Esophageal Cancer Survival After Surgery
Racial Disparities in Esophageal Cancer Survival After Surgery
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DOI：
10.1002/jso.24203
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发表时间：
2016-05-01
影响因子：
2.5
通讯作者：
Flores, Raja M.
中科院分区：
文献类型：
--
作者：
Taioli, Emanuela;Wolf, Andrea S.;Flores, Raja M.
目的：食管癌（EC）黑人患者的死亡率高于白人。黑人的手术率较低可以解释生存率的差异。我们探索了监测流行病学和最终结果数据库，以确定手术对黑人和白人EC.Methods死亡率的影响：确定了1973年至2011年经病理证实的食管局部和局部腺癌和鳞状细胞癌的所有病例（13，678例白色，2，894例黑人患者）。排除颈段食管癌。年龄，性别，诊断年，阶段，癌症定向手术，放射治疗，和生命状态进行了分析，根据自我报告的race.Results：黑人有较高的1年死亡率，调整年龄，性别，阶段，年的诊断，组织学和治疗[调整后的危险比（HRadj）：1.24（95%CI 1.16-1.32）]。接受手术是总体生存率改善的独立预测因素（HRadj 0.30，95% CI 0.27-0.33）。手术治疗的黑人患者的生存率显着低于白人，但差异没有观察到在那些谁没有接受surgery.Conclusions：虽然手术似乎降低死亡率的整体，早期生存是更糟糕的黑人。调查种族差异的卫生保健的获取和提供，并熟练的食管外科医生是必要的，以提高生存率的所有患者，特别是黑人。(C)2016 Wiley Periodicals，Inc.
Objectives: Esophageal cancer (EC) black patients have higher mortality rates than Whites. The lower rate of surgery in Blacks may explain the survival difference. We explored the Surveillance Epidemiology and End Results database to determine the impact of surgery on mortality in Blacks and Whites EC.Methods: All cases of pathologically proven local and locoregional adenocarcinoma and squamous cell carcinoma of the esophagus from 1973 to 2011 were identified (13,678 White, 2,894 Black patients). Cervical esophageal cancer was excluded. Age, sex, diagnosis year, stage, cancer-directed surgery, radiation, and vital status were analyzed according to self-reported race.Results: Blacks had higher 1-year mortality, adjusted for age, sex, stage, year of diagnosis, histology, and therapy [adjusted hazard ratio (HRadj): 1.24 (95% CI 1.16-1.32)]. Undergoing surgery was an independent predictor of improved survival overall (HRadj 0.30, 95% CI 0.27-0.33). Black patients treated surgically experienced significantly lower survival than Whites, but the difference was not observed in those who did not undergo surgery.Conclusions: Although surgery appears to reduce mortality overall, early survival is worse for Blacks. Investigation into racial disparities in health care access and delivery, and to skilled esophageal surgeons is warranted to improve survival for all patients, particularly Blacks. (C) 2016 Wiley Periodicals, Inc.