Impact of Race and Health Insurance Status on Response to Neoadjuvant Chemotherapy for Breast Cancer Patients.
Impact of Race and Health Insurance Status on Response to Neoadjuvant Chemotherapy for Breast Cancer Patients.
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DOI：
10.7759/cureus.16127
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Thomas TO
中科院分区：
文献类型：
--
作者：
Ho Y;Harris A;Wesolowski M;Refaat T;Small W Jr;Thomas TO
我们评估了种族、保险状况和其他社会人口统计学、肿瘤和治疗变量如何影响乳腺癌新辅助化疗（NAC）的反应。我们对2006年至2018年在我们机构接受NAC治疗的298例乳腺癌患者进行了IRB批准的回顾性审查。进行单变量和多变量二元logistic回归分析，以估计种族、保险状况和其他变量对结局的影响。关注的结局包括病理完全缓解（pCR）、部分缓解（pPR）和任何缓解（pCR或pPR）。69例患者（23%）被确定为非裔美国人。168名（57%）患者有私人保险，71名（24%）有医疗保险，40名（14%）有医疗补助，17名（6%）没有保险。在单变量和多变量分析中，保险状况是NAC临床反应的预测因素（p<0.01），其中与私人保险相比，医疗保险患者的pCR或pPR几率较低（OR 0.32，95% CI：0.15-0.70，p<0.01）。对NAC反应有意义的其他变量包括体重指数、激素受体状态、临床组分期和Ki-67。种族不影响对NAC的反应。保险提供者、体重指数、激素受体状态、临床分期和Ki-67可能是治疗结果的有用预测因素。未来的研究评估保险状况和其他确定的因素对治疗反应的影响，可能有助于评估风险人群的结果，这些人群的因素排除了NAC的充分获益。
We evaluated how race, insurance status, and other sociodemographic, tumor, and treatment variables influenced the response to neoadjuvant chemotherapy (NAC) in breast cancer. We performed an IRB-approved retrospective review of 298 breast cancer patients treated with NAC from 2006-2018 at our institution. Univariable and multivariable binary logistic regression analyses were performed to estimate the effects of race, insurance status, and other variables on outcomes. Outcomes of interest included pathologic complete response (pCR), partial response (pPR), and any response (pCR or pPR). Sixty-nine patients (23%) identified as African American. One hundred sixty-eight (57%) patients had private insurance, 71 (24%) had Medicare, 40 (14%) had Medicaid, and 17 (6%) had no insurance. Insurance status was a predictor for any clinical response to NAC in both univariable and multivariable analyses (p<0.01), where odds of pCR or pPR were lower for patients with Medicare compared to private insurance (OR 0.32, 95% CI: 0.15-0.70, p<0.01). Other variables significant for the response to NAC included body mass index, hormone receptor status, clinical group stage, and Ki-67. Race did not influence the response to NAC. Insurance provider, body mass index, hormone receptor status, clinical group stage, and Ki-67 may be useful predictors of treatment outcomes. Future studies that assess the impacts of insurance status and other identified factors on treatment response may help evaluate outcomes in at-risk populations with factors that preclude full benefit from NAC.
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影响因子：
45.3
作者：
Killelea, Brigid K.;Yang, Vicky Q.;Lannin, Donald R.
通讯作者：
Lannin, Donald R.
DOI：
10.1016/s1470-2045(17)30777-5
发表时间：
2018-01
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
通讯作者：
Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
影响因子：
10.3
作者：
COATES, RJ;CLARK, WS;BROWN, RL
通讯作者：
BROWN, RL
影响因子：
158.5
作者：
AYANIAN, JZ;KOHLER, BA;EPSTEIN, AM
通讯作者：
EPSTEIN, AM
影响因子：
6.2
作者：
Andersen, Barbara L.;Yang, Hae-Chung;Farrar, William B.;Golden-Kreutz, Deanna M.;Emery, Charles F.;Thornton, Lisa M.;Young, Donn C.;Carson, William E., III
通讯作者：
Carson, William E., III