Carlson Matthew L, Marston Alexander P, Glasgow Amy E, Habermann Elizabeth B, Sweeney Alex D, Link Michael J, Wanna George B
Department of Otorhinolaryngology, Mayo Clinic School of Medicine, Rochester, Minnesota.
Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota.
Laryngoscope. 2016 Sep;126(9):2128-33. doi: 10.1002/lary.25892. Epub 2016 Feb 24.
OBJECTIVES/HYPOTHESIS: To estimate the impact of race on disease presentation and treatment of vestibular schwannoma (VS) in the United States.
Analysis of a national population-based tumor registry.
Analysis of the Surveillance, Epidemiology, and End Results database was performed, including all patients identified with a diagnosis of VS. Associations between race, disease presentation, treatment strategy, and overall survival were analyzed in a univariate and multivariable model.
A total of 9,782 patients with VS were identified among 822 million person-years. Of these, 7,400 (75.6%) claimed white, 807 (8.2%) Hispanic, 755 (7.7%) Asian, 397 (4.1%) black, and 423 (4.3%) patients reported other race. The median annual incidence of disease was lowest among black (0.43 per 100,000 persons) and Hispanic populations (0.45 per 100,000 persons) and highest among white (1.61 per 100,000 persons) populations (P < 0.001). Overall, Hispanic patients were diagnosed at the youngest age, and white patients were diagnosed at the oldest age (mean of 50.0 vs. 56.0 years, respectively; P < 0.001). Compared to white populations, black, Hispanic, and Asian populations were more likely to present with larger tumors (P < 0.001). After controlling for tumor size, age, and treatment center in a multivariable model, Hispanic patients were more likely than white patients to undergo surgery (P = 0.010); however, there were no differences between white, black, and Asian populations with regard to treatment modality. Hispanic and black patients had the poorest overall survival following surgery compared to other groups.
Racial differences among patients with VS exist within the United States. Further studies are required to determine which factors drive differences in tumor size, age, annual disease incidence, and overall survival between races.
目的/假设：评估种族对美国前庭神经鞘瘤（VS）疾病表现及治疗的影响。
基于全国人群的肿瘤登记分析。
对监测、流行病学及最终结果数据库进行分析，纳入所有确诊为VS的患者。在单变量和多变量模型中分析种族、疾病表现、治疗策略及总生存率之间的关联。
在8.22亿人年中，共识别出9782例VS患者。其中，7400例（75.6%）为白人，807例（8.2%）为西班牙裔，755例（7.7%）为亚裔，397例（4.1%）为黑人，423例（4.3%）患者报告为其他种族。疾病的年发病率中位数在黑人（每10万人中0.43例）和西班牙裔人群（每10万人中0.45例）中最低，在白人（每10万人中1.61例）人群中最高（P < 0.001）。总体而言，西班牙裔患者诊断时年龄最小，白人患者诊断时年龄最大（平均分别为50.0岁和56.0岁；P < 0.001）。与白人相比，黑人、西班牙裔和亚裔人群更易出现较大肿瘤（P < 0.001）。在多变量模型中控制肿瘤大小、年龄和治疗中心后，西班牙裔患者比白人患者更易接受手术（P = 0.010）；然而，在治疗方式上，白人、黑人和亚裔人群之间无差异。与其他组相比，西班牙裔和黑人患者术后总生存率最差。
美国VS患者存在种族差异。需要进一步研究以确定哪些因素导致不同种族在肿瘤大小、年龄、年发病率及总生存率方面存在差异。
3。《喉镜》，126:2128 - 2133，2016年。
