Differences in Sociodemographic Disparities Between Patients Undergoing Surgery for Advanced Colorectal or Ovarian Cancer.
Differences in Sociodemographic Disparities Between Patients Undergoing Surgery for Advanced Colorectal or Ovarian Cancer.
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DOI：
10.1245/s10434-021-10086-y
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发表时间：
2021-11
影响因子：
3.7
通讯作者：
Eng OS
中科院分区：
文献类型：
--
作者：
Goldberg EM;Berger Y;Sood D;Kurnit KC;Kim JS;Lee NK;Yamada SD;Turaga KK;Eng OS
卵巢癌伴腹膜转移（OPM）的细胞减灭术（CRS）是一种既定的治疗方法，但与入路相关的种族和社会经济差异已得到充分证明。CRS用于结直肠癌腹膜转移（CRPM）正在获得更广泛的接受，目前尚不清楚在获取方面存在哪些差异。这项回顾性横断面多中心研究分析了2010-2015年国家癌症数据库的医疗记录。包括仅诊断为CRPM或ORP且未切除或确认切除的患者。使用单变量和多变量logistic回归分析患者水平和机构水平的特征，以确定与接受CRS的相关性。本研究共纳入了6，634例诊断为CRPM的患者和14，474例诊断为OPM的患者。在CRPM患者中，18.1%发生CRS。在多变量分析中，女性（比值比[95%CI]; 2.04 [1.77-2.35]; P<0.001）和在学术或研究机构接受治疗（OR 1.55 [1.17-2.05]; P= 0.002）与CRS相关。在OPM患者中，87.1%经历了CRS。在多变量分析中，在高收入患者群体的机构接受治疗与CRS呈正相关，而年龄（OR 0.97 [0.96-0.98]; P<.001），使用非私人保险（OR 0.69 [0.56-0.85]; P=.001），并列为黑色（OR 0.62 [0.45-0.86]; P=.004）与CRS呈负相关。与CRPM患者相比，OPM患者的CRS系统性障碍更多。随着CRS越来越广泛地应用于CRPM，可能会阐明更多的社会经济和人口障碍。
Cytoreductive surgery (CRS) for ovarian cancer with peritoneal metastases (OPM) is an established treatment, yet access-related racial and socioeconomic disparities are well documented. CRS for colorectal cancer with peritoneal metastases (CRPM) is garnering more widespread acceptance, and it is unknown what disparities exist with regards to access. This retrospective cross-sectional multicenter study analyzed medical records from the National Cancer Database from 2010–2015. Patients diagnosed with CRPM or ORP only and either no resection or confirmed resection were included. Patient-level and facility-level characteristics were analyzed using univariate and multivariable logistic regressions to identify associations to receipt of CRS. A total of 6,634 patients diagnosed with CRPM and 14,474 diagnosed with OPM were included in this study. Among patients with CRPM, 18.1% underwent CRS. In the multivariable analysis, female gender (odds ratio [95% CI]; 2.04 [1.77—2.35]; P<.001) and treatment at an academic or research facility (OR 1.55 [1.17—2.05]; P=.002) were associated with CRS. Among patients with OPM, 87.1% underwent CRS. In the multivariable analysis, treatment at facilities with higher-income patient populations was positively associated with CRS, while age (OR 0.97 [0.96—0.98]; P<.001), use of non-private insurance (OR 0.69 [0.56—0.85]; P=.001), and listed as Black (OR 0.62 [0.45—0.86]; P=.004) were negatively associated with CRS. There were more systemic barriers to CRS for patients with OPM than for patients with CRPM. As CRS becomes more widely practiced for CRPM, it is likely that more socioeconomic and demographic barriers will be elucidated.
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影响因子：
3.9
作者：
Healy MA;Pradarelli JC;Krell RW;Regenbogen SE;Suwanabol PA
通讯作者：
Suwanabol PA
影响因子：
4
作者：
Ihemelandu CU;Shen P;Stewart JH;Votanopoulos K;Levine EA
通讯作者：
Levine EA
影响因子：
6.2
作者：
Farley, John H.;Tian, Chunqiao;Maxwell, G. Larry
通讯作者：
Maxwell, G. Larry
影响因子：
--
作者：
Hussain, Tanvir;Chang, Hsien-Yen;Pollack, Craig E.
通讯作者：
Pollack, Craig E.
DOI：
10.1067/s0002-9378(03)00579-9
发表时间：
2003-10-01
影响因子：
9.8
作者：
Barnholtz-Sloan, JS;Schwartz, AG;Munkarah, AR
通讯作者：
Munkarah, AR