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Survival Advantage of Non-hispanic White Patients with Pancreatic Head Carcinoma: A Population-based Study

机译:非西班牙裔白癌患者胰头癌的生存优势:基于人群的研究

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Numerous studies have shown that racial health disparities in gastroenterology and hepatology, but little is known about its effect on pancreatic head carcinoma (PHC). The aim of the present study was to determine whether racial disparities in the overall survival (OS) and cancer-specific survival (CSS) rates exist among US patients with PHC. The SEER database was searched for US residents who had been diagnosed with PHC from 2007 to 2015. The outcomes for 9724 Hispanic white (HW) patients and their non-Hispanic white (NHW) counterparts were compared using Kaplan-Meier survival and Cox regression analyses. We found that race affected both OS and CSS. The 5-year OS rate was worse for HW patients (45.9%) than for NHW patients (49.6%, P0.001), as was the 5-year CSS rate (39.8% versus 44.0%, P=0.002). Race appeared to be an independent prognostic factor for PHC in the multivariate analysis, with NHW patients showing superior OS (P=0.007) and CSS (P=0.037) compared with HW patients. Subgroup analysis showed that race influenced survival among patients who received surgery, enjoyed Medicaid, and those at American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) stage II, but not of patients at AJCC TNM stage I, III, or IV and those who did not receive surgery or had no insurance. In short, the survival outcomes for PHC are better for NHW than HW patients. The survival advantage is more skewed towards NHW patients than HW patients with PHC, so culturally appropriate interventions, strengthened preventive services, and additional financial support should focus more on HWs.
机译:许多研究表明,胃肠病学和肝脏的种族健康差异,但对其对胰头癌(PHC)的影响很少。本研究的目的是确定美国PHC患者的整体存活(OS)和癌症特异性存活率(CSS)率是否存在种族差异。从2007年至2015年被诊断出诊断博士的美国居民被检察。使用Kaplan-Meier生存和Cox回归分析进行比较9724西班牙裔(HW)患者及其非西班牙裔(NHW)对应物的结果。我们发现竞赛影响了OS和CSS。对于NHW患者(49.6%,P <0.001)而言,5年的OS率较差(45.9%),而5年的CSS率(39.8%对44.0%,P = 0.002)。与HW患者相比,种族在多变量分析中似乎是PHC的独立预后因素,所述NHW患者(P = 0.007)和CSS(P = 0.037)相比,患者(P = 0.007)。亚组分析表明,接受手术,医疗补助的患者和美国联合癌症患者(AJCC)肿瘤节点转移(TNM)第II阶段的患者的群体影响生存,但不是AJCC TNM阶段I,III,或IV和那些没有接受手术或没有保险的人。简而言之,PHC的存活结果比HW患者更好。生存优势比HW患者更偏向,而不是PHC患者,如此文化适当的干预,加强预防服务,额外的金融支持应更多地关注HWS。

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