Hamid Muhammad Saad, Shameem Raji, Gafoor Khalid, George Jason, Mina Bushra, Sullivan Kevin
Department of Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, MI 48201, USA.
Department of Hematology-Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
J Cancer Epidemiol. 2015;2015:269304. doi: 10.1155/2015/269304. Epub 2015 Jan 15.
Background. The objective of our study was to ascertain racial/ethnic disparities in Asian/Pacific Islanders (API) for non-small-cell lung cancer (NSCLC) clinicopathologic features and survival outcomes based on various tumor characteristics and treatment modalities. Method. SEER database identified invasive NSCLC cases from 2004 to 2010. Variables included American Joint Committee on Cancer (AJCC) stage 7, tumor grade, tumor size, histology, age, marital status, radiation, surgery, and reason for no surgery. The Kruskall-Wallis test and the Z test were used to examine differences between races/ethnicities and the referent, non-Hispanic white (NHW). Multivariate Cox proportional analyses were used to establish the weight of the prognostic significance contributing to disease-specific survival (DSS) in each AJCC stage. Result. Improved DSS was seen in API across stage I (HR: 0.78), stage II (HR: 0.79), and stage IV (HR: 0.86), respectively, compared to the referent NHW (P < 0.01). Prognosis was improved by being married, being female gender, AIS histology, and birth outside the US (P < 0.01). Conclusion. We have demonstrated improved survival among API in early stage and stage IV NSCLC. Further research is necessary to clarify the role of lifestyle and tumor biology for these differences.
背景。我们研究的目的是根据各种肿瘤特征和治疗方式，确定亚洲/太平洋岛民（API）在非小细胞肺癌（NSCLC）临床病理特征和生存结果方面的种族/民族差异。方法。监测、流行病学和最终结果（SEER）数据库确定了2004年至2010年的侵袭性NSCLC病例。变量包括美国癌症联合委员会（AJCC）第7版分期、肿瘤分级、肿瘤大小、组织学、年龄、婚姻状况、放疗、手术以及未进行手术的原因。采用Kruskal-Wallis检验和Z检验来检验种族/民族与参照组非西班牙裔白人（NHW）之间的差异。多变量Cox比例分析用于确定每个AJCC分期中对疾病特异性生存（DSS）有预后意义的权重。结果。与参照组NHW相比，API在I期（风险比：0.78）、II期（风险比：0.79）和IV期（风险比：0.86）的DSS均有所改善（P<0.01）。已婚、女性、原位腺癌（AIS）组织学以及在美国境外出生可改善预后（P<0.01）。结论。我们已经证明，API在早期和IV期NSCLC中的生存率有所提高。有必要进一步研究以阐明生活方式和肿瘤生物学在这些差异中所起的作用。
