Roach M, Alexander M, Coleman J L
Radiation Oncology Service, Martinez Veterans Administration Medical Center, California.
J Natl Med Assoc. 1992 Aug;84(8):668-74.
Surveillance, Epidemiology, and End Results (SEER) program data suggest that blacks with laryngeal carcinoma have a significantly lower 5-year survival rate than whites. Most of this difference persists despite adjustment for "crude stage." To evaluate possible factors contributing to this residual survival deficit, 190 white and 23 black patients treated at the Martinez Veterans Administration Hospital between 1968 and 1988 were studied. The independent impact of race on survival rate was analyzed with respect to various prognostic factors including treatment delay, elapsed time (diagnosis to treatment), age, stage, cancer subsites, and type of therapy. No independent prognostic significance could be attributed to race. The differences noted in SEER data probably reflect a tendency for the use of crude stage to underestimate the impact of prognostic groups within the categories of "local" and "regional" disease, the independent prognostic significance of subsites (glottic versus supraglottic), and the variable distribution of these subsites in different populations. This study suggests that when stage, subsite, and quality of care are adequately considered, survival from laryngeal cancer in blacks is comparable to that of whites.
监测、流行病学与最终结果（SEER）项目数据表明，喉癌黑人患者的5年生存率显著低于白人患者。即便对“粗略分期”进行校正后，这种差异仍大多存在。为评估可能导致这种残余生存差异的因素，我们对1968年至1988年间在马丁内斯退伍军人管理局医院接受治疗的190名白人患者和23名黑人患者进行了研究。针对包括治疗延迟、病程（从诊断到治疗的时间）、年龄、分期、癌症亚部位以及治疗类型等多种预后因素，分析了种族对生存率的独立影响。种族并无独立的预后意义。SEER数据中所指出的差异可能反映出一种趋势，即使用粗略分期往往会低估“局部”和“区域”疾病类别中预后分组的影响、亚部位（声门型与声门上型）的独立预后意义，以及这些亚部位在不同人群中的可变分布。本研究表明，当充分考虑分期、亚部位和医疗质量时，黑人喉癌患者的生存率与白人相当。
