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