在甲状腺癌存活率差异中的手术时间的种族影响
Andrea Gillis1, Polina Zmijewski1, M Chandler Mcleod1
1University of Alabama At Birmingham, Department of General Surgery, USA.
American journal of surgery
|March 22, 2024
概括
推迟乳头甲状腺癌 (PTC) 手术会使生存率恶化. 黑人患者的结果较差,即使控制了手术的时间,这也表明甲状腺癌生存率的持续种族差异.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 健康差距 研究 研究 研究 研究
背景情况:
- 癌症存活率的种族和民族差异是一个重大的公共卫生问题.
- 手术时间对皮肤状甲状腺癌 (PTC) 的生存结果的影响尚未完全阐明,特别是在种族/民族差异方面.
研究的目的:
- 为了研究局部乳头甲状腺癌患者手术时间和存活率之间的关联.
- 为了确定PTC存活率是否存在种族/民族差异,无论手术干预的时间如何.
主要方法:
- 从2004年至2017年利用了国家癌症数据库 (NCDB),其中包括126,708名局部PTC患者.
- 基于手术前的时间和患者人口统计数据进行了生存数据的比较.
- 进行多变量考克斯回归分析以确定生存的独立预测因素.
主要成果:
- 与黑人 (43天) 和西班牙裔 (42天) 患者 (p < 0.001) 相比,非西班牙裔白人患者的手术时间中位数较短 (36天).
- 手术后的较长时间 (>90天 vs. <30天) 与明显更差的存活率有关 (HR: 1.56,p < 0.001).
- 与非西班牙裔白人患者相比,黑人种族独立地与更差的生存率有关 (HR:1.21,p = 0.001),无论手术延迟.
结论:
- 对乳头甲状腺癌的延迟手术干预与患者生存率较差有关.
- 在PTC存活率上存在显著的种族差异,黑人患者面临的结果更糟糕,独立于手术时间和其他混因素.
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