回顾性研究论文确定胰腺癌患者的种族差异

Chibueze Onyemkpa, Danielle Dougherty, Sajjaad Samat, Tolutope Oyasiji, Michael McLeod
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摘要

背景:胰腺癌是美国癌症死亡的第四大原因。一直存在种族不平等的假设。在此基础上,我们主要研究了种族的存在,用于胰腺癌的诊断和治疗。方法:使用监测流行病学和最终结果-医疗保险登记对胰腺癌患者进行回顾性评价。进行单因素和多因素分析。总体生存分析采用Kaplan-Meier曲线。生存曲线比较采用对数秩检验。采用Cox比例风险回归模型确定独立的生存预测因子。其他领域的重点是“从诊断到治疗的时间间隔”,“原发部位手术的预测因素”,“推荐原发部位手术的预测因素”,“肿瘤切除的预测因素”,“推荐原发部位手术的表现和拒绝手术的预测因素”,以及“任何其他治疗(除手术外的所有治疗)的预测因素”。结果:从数据库中共识别出52,951例患者。男性24,523人,女性26,715人。81.9%为白种人,10.9%为黑人,7.2%为其他种族。不同阶段在两性之间的分布大致相等。女性诊断为ⅰ期的比例为10.2%,ⅰ期、ⅱ期和ⅳ期分别为28.9%、9.3%和51.6%,男性诊断为ⅰ期、ⅱ期、ⅰ期和ⅳ期的比例分别为8.4%、28.3%、9.2%和54.1%。9.5%的黑人患者被诊断为I期,24.2%为II期,10.1%为III期,56.2%为IV期。在其他种族中也有类似的分布。与白种人(p=0.004)和其他种族(p= 0.001)相比,黑人患者的总生存率更差。结论:与白种人患者相比,黑人胰腺癌患者的总生存期较差。
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Retrospective review paper identification racial disparities in patients with pancreatic cancer
Background: Pancreatic cancer is the fourth leading cause of cancer death in the US. There has been postulates of racial disparities. Based on this, we primarily examined the presence of race, for the diagnosis and treatment of pancreatic cancer. Methods: A retrospective review was conducted on patients with pancreatic cancers using the Surveillance Epidemiology, and End Results - Medicare registry. Univariate and multivariate analyses were performed. Overall Survival analysis was done using the Kaplan-Meier curve. Comparison of survival curves was done using the log rank test. Cox proportional hazards regression model was used to determine independent predictors of survival. Other areas focused on were Time interval from diagnosis to treatment”, “Predictors of Surgery of the primary site”, “Predictors for recommending surgery of the primary site”, “Predictors for oncologic resection”, “Predictors of performance and refusal of surgery of primary site if recommended”, and “Predictors for any other therapy (all therapies excluding surgery). Results: A total of 52,951 patients were identified from the database. 24, 523 were males and 26, 715 were females. 81.9% were Caucasian, 10.9% were black and 7.2% were other races. There was approximately equal distribution of the different stages between both genders. 10.2% of the females were diagnosed at stage I, 28.9%, 9.3% and 51.6% at stages I, Ill and IV respectively compared to males with 8.4% 28.3%, 9.2% and 54.1% for stages I, II, Ill and IV respectively. 9.5% of the black patients were diagnosed at stage I, 24.2% at stage II, 10.1% at stage III and 56.2% at stage IV. A similar distribution was noted in the other races. Black patients had worse overall survival when compared to Caucasians (p=0.004) and other races (p = 0.001). Conclusion: Compared to Caucasian patients, black patients with pancreatic cancer had worse overall survival.
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