Isherwood J, Bilku D, Metcalfe M S, Dennison A R, Garcea G
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK.
World J Surg. 2017 Feb;41(2):546-551. doi: 10.1007/s00268-016-3707-7.
Despite increasingly mixed communities in large cities, there remains a paucity of absolute and comparative data concerning the treatment, access and survival of British Asians with pancreatic cancer.
A prospective database of 1038 patients with a diagnosis of pancreatic cancer from 2003 to 2012 was analysed. Asian/Asian British was defined as patients identifying themselves as originating from India, Bangladesh or Pakistan.
No significant difference was observed in gender split for both Asian/Asian British and White British (AAB and WB). The incidence of pancreas cancer was also equivalent between the two groups at 8.1 versus 8.8 per 100,000 of the population. Age at presentation was significantly younger in AABs when compared to WBs (67 vs. 70 years, p = 0.003). Whilst median maximal tumour diameter, node status and the incidence of metastases were not different between AABs and WBs, the AABs had a significantly greater median T-stage (3.0 versus 2.5, p = 0.0024). The percentage of patients referred for chemotherapy was significantly higher in the AAB group (70.5 vs. 47.7 %, p = 0.0015). Overall survival and survival for patients having palliative treatment were significantly greater in AABs (4.6 vs. 6.1 months and 3.7 vs. 5.1 months).
This study demonstrates that AAB patients are present with pancreatic cancer at a younger age and that when receiving palliative chemotherapy their survival is significantly better. Further studies and larger data sets over a longer period are required. It is important to examine further the complexity of incidence and survival in ethnic minorities and investigate the underlying reasons when differences are demonstrated.
尽管大城市中的社区日益多元化，但关于英国亚裔胰腺癌患者的治疗、就医机会和生存率的绝对数据和比较数据仍然匮乏。
对2003年至2012年诊断为胰腺癌的1038例患者的前瞻性数据库进行分析。亚裔/英籍亚裔定义为自认为来自印度、孟加拉国或巴基斯坦的患者。
亚裔/英籍亚裔和英籍白人（AAB和WB）的性别分布无显著差异。两组胰腺癌的发病率也相当，分别为每10万人中8.1例和8.8例。与WB相比，AAB的就诊年龄显著更年轻（67岁对70岁，p = 0.003）。虽然AAB和WB之间的最大肿瘤直径中位数、淋巴结状态和转移发生率没有差异，但AAB的T分期中位数显著更高（3.0对2.5，p = 0.0024）。AAB组接受化疗的患者百分比显著更高（70.5%对47.7%，p = 0.0015）。AAB的总体生存率和接受姑息治疗患者的生存率显著更高（4.6个月对6.1个月和3.7个月对5.1个月）。
本研究表明，AAB患者患胰腺癌的年龄更年轻，接受姑息化疗时生存率显著更高。需要进一步的研究和更长时间的更大数据集。进一步研究少数族裔发病率和生存率的复杂性并调查出现差异的潜在原因很重要。
