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比较拉美裔和非拉美裔的尤文肉瘤患者。

Comparison of Latino and non-Latino patients with Ewing sarcoma.

机构信息

Department of Pediatrics, San Francisco School of Medicine, University of California, San Francisco, California; Department of Pathology, San Francisco School of Medicine, University of California, San Francisco, California.

出版信息

Pediatr Blood Cancer. 2014 Feb;61(2):233-7. doi: 10.1002/pbc.24745. Epub 2013 Aug 23.

Abstract

BACKGROUND

Ewing sarcoma (ES) is a malignancy of bone and soft tissue in children and adults. Previous registry-based studies indicate that Latino patients with ES have inferior outcomes compared to non-Latino patients, though an etiology for this difference could not be identified. To explore possible differences that might underlie this disparity, we conducted a retrospective study to compare clinical characteristics, tumor features, healthcare access, and treatment outcomes between Latino and non-Latino patients with ES.

METHODS

Primary data for 218 ES patients treated at two academic medical centers between 1980 and 2010 were collected. Categorical data were compared using Fisher exact tests; Wilcoxon rank-sum tests were used for continuous variables. Survival was estimated using Kaplan-Meier analysis and compared using log-rank testing.

RESULTS

Latino patients were diagnosed at a younger age (P = 0.014). All other clinical and histological data were similar between groups, including radiologic and histologic response to neoadjuvant chemotherapy. Latino patients had lower socioeconomic status (P = 0.001), were less likely to have insurance (P = 0.001), and were more likely to present to the emergency room at onset of symptoms (P = 0.031) rather than to primary care physicians. Five-year event free survival (EFS) and overall survival (OS) were similar between Latino and non-Latino patients (EFS: 60.5% vs. 50.9% P = 0.37; OS: 77.6% vs. 68.6% P = 0.54).

CONCLUSION

Latino patients with ES present at a younger age, and have evidence of impaired access to healthcare. Response to initial therapy appears similar between Latino and non-Latino patients.

摘要

背景

尤因肉瘤(ES)是儿童和成人的骨骼和软组织恶性肿瘤。以前基于登记的研究表明,与非拉丁裔患者相比,拉丁裔 ES 患者的预后较差,但无法确定这种差异的病因。为了探讨可能导致这种差异的原因,我们进行了一项回顾性研究,比较了拉丁裔和非拉丁裔 ES 患者的临床特征、肿瘤特征、医疗保健获取和治疗结果。

方法

收集了 1980 年至 2010 年在两个学术医疗中心接受治疗的 218 名 ES 患者的原始数据。使用 Fisher 精确检验比较分类数据;使用 Wilcoxon 秩和检验比较连续变量。使用 Kaplan-Meier 分析估计生存率,并使用对数秩检验进行比较。

结果

拉丁裔患者的诊断年龄较小(P = 0.014)。两组之间的所有其他临床和组织学数据均相似,包括新辅助化疗的放射学和组织学反应。拉丁裔患者的社会经济地位较低(P = 0.001),保险覆盖率较低(P = 0.001),并且在出现症状时更有可能去急诊室就诊(P = 0.031),而不是去初级保健医生就诊。拉丁裔和非拉丁裔患者的 5 年无事件生存率(EFS)和总生存率(OS)相似(EFS:60.5%比 50.9%,P = 0.37;OS:77.6%比 68.6%,P = 0.54)。

结论

患有 ES 的拉丁裔患者的发病年龄较小,并且在获得医疗保健方面存在证据表明存在障碍。初始治疗的反应在拉丁裔和非拉丁裔患者之间似乎相似。

相似文献

1
Comparison of Latino and non-Latino patients with Ewing sarcoma.比较拉美裔和非拉美裔的尤文肉瘤患者。
Pediatr Blood Cancer. 2014 Feb;61(2):233-7. doi: 10.1002/pbc.24745. Epub 2013 Aug 23.

本文引用的文献

1
Ethnicity and age disparities in Ewing sarcoma outcome.尤因肉瘤预后中的种族和年龄差异。
Fetal Pediatr Pathol. 2013 Jul;32(4):246-52. doi: 10.3109/15513815.2012.721480. Epub 2012 Oct 8.

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