社会经济贫困对工人联合会阶段化,死亡率和复发的影响
Eric R Wahlstedt1, Ajay K Varadhan2, John C Wahlstedt3
1University of Kentucky College of Medicine, Lexington, KY.
Urology
|December 14, 2024
概括
区域剥夺指数 (ADI) 并没有显著影响上道泌尿道癌 (UTUC) 阶段,复发或生存. 这表明,改善医疗保健准入可能正在缓解工商联合会结果中的社会经济差异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 社会经济地位 (SES) 与癌症发病率和结局有关.
- 区域贫困指数 (ADI) 量化了社区层面的社会经济劣势.
- ADI对上道泌尿道癌 (UTUC) 的影响尚未得到充分证实.
研究的目的:
- 调查社会经济地位的衡量标准ADI与UTUC患者的治疗结果之间的关联.
- 确定ADI是否影响UTUC瘤阶段,复发率和患者死亡率.
主要方法:
- 对215名"有利"和217名"不利"的UTUC患者的回顾性分析,基于ADI (第50百分点截止值).
- 在ADI组之间比较瘤特征,病理阶段和新辅助化疗使用.
- 使用Mantle-Cox日志等级测试评估无复发生存率 (RFS) 和整体生存率 (OS).
主要成果:
- 在优势和弱势群体之间,积极切除边缘,瘤大小或病理性瘤/节点阶段没有显著差异.
- 在优势组中,新辅助化疗的使用率较高 (20%对13%,P=.035),但在四分位数中并不显著.
- 在SES组中,中位数RFS和OS在SES组之间是相似的.
结论:
- 作为SES的替代品,ADI在这个队列中没有对UTUC分期,复发或生存产生重大影响.
- 结果可能表明,在医疗保健获取和基于证据的护理提供方面,成功的干预措施缓解了工商联合会中与SES相关的差异.
- 需要进一步的研究来证实这些区域观察,并探索有助于因素.
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