美国口腔和口咽癌长期生存中的种族和性别差异。
Race and sex disparities in long-term survival of oral and oropharyngeal cancer in the United States.
作者信息
Osazuwa-Peters Nosayaba, Massa Sean T, Christopher Kara M, Walker Ronald J, Varvares Mark A
机构信息
Saint Louis University Cancer Center, 3655 Vista Avenue, Saint Louis, MO, 63110, USA.
Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, 3635 Vista Avenue, 6th Floor Desloge Towers, Saint Louis, MO, 63110-2539, USA.
出版信息
J Cancer Res Clin Oncol. 2016 Feb;142(2):521-8. doi: 10.1007/s00432-015-2061-8. Epub 2015 Oct 28.
PURPOSE
To investigate the effect of race and sex on long-term survival of oral and oropharyngeal cancer.
METHODS
The Surveillance, Epidemiology and End Results database was queried for adult oral and oropharyngeal cancer patients with at least 25-year follow-up. Kaplan-Meier survival curves and cox proportional hazards model were used to identify differences.
RESULTS
Of the 22,162 patients identified, 70.3% were males. Only 8.9% were alive at 25 years post-diagnosis. Black males show the poorest overall and disease-specific survival rates (p < 0.001). After controlling for covariates, Blacks had a 40% higher hazard of mortality compared with Whites (HR 1.40, 95% CI 1.35-1.46), while females had a 9% reduction in mortality risk (HR 0.91, 95% CI 0.88-0.94).
CONCLUSIONS
Overall and disease-specific survival is poor for oral and oropharyngeal cancer patients, and Black men fare worst. This illustrates the need for long-term cancer survival plans incorporating disparity effects in overall cancer outcomes.
目的
探讨种族和性别对口腔及口咽癌长期生存的影响。
方法
在监测、流行病学和最终结果数据库中查询至少有25年随访期的成年口腔及口咽癌患者。采用Kaplan-Meier生存曲线和Cox比例风险模型来确定差异。
结果
在确定的22162例患者中，70.3%为男性。诊断后25年时仅有8.9%的患者存活。黑人男性的总体生存率和疾病特异性生存率最差（p<0.001）。在控制协变量后，黑人的死亡风险比白人高40%（风险比1.40，95%置信区间1.35-1.46），而女性的死亡风险降低9%（风险比0.91，95%置信区间0.88-0.94）。
结论
口腔及口咽癌患者的总体生存率和疾病特异性生存率较差，黑人男性情况最差。这表明需要制定长期癌症生存计划，将差异影响纳入总体癌症结局。
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