Ross Jerlinda, Braswell Katelyn V, Madeira da Silva Luciana, Mujica Frances, Stutsman Sam, Finan Michael A, Nicolson William, Harmon Mary Danner, Missanelli Megan, Cohen Alex, Singh Ajay, Scalici Jennifer M, Rocconi Rodney P
University of Chicago, Gynecologic Oncology Division, Chicago, IL, USA.
Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA.
Gynecol Oncol. 2017 May;145(2):329-333. doi: 10.1016/j.ygyno.2017.02.025. Epub 2017 Feb 16.
Our objective was to evaluate racial treatment and survival disparities in black women with ovarian cancer in the Deep South and to determine how environmental factors / socioeconomic status (SES) influence survival.
A retrospective study of ovarian cancer patients from 2007 to 2014 was performed. Socioeconomic status (SES) was obtained though U.S. Census block data and compared using Yost scores. Comparisons were performed using standard statistical approaches.
A total of 393 patients were evaluated, 325 (83%) white and 68 (17%) black. Demographic information and surgical approach were similar in each racial group. However, compared to whites, black patients had lower rates of optimal debulking [89% vs. 71%, respectively (p=0.001)] and intraperitoneal chemotherapy (19% vs. 11%, p=0.01). Black women had lower SES parameters including education, income, and poverty. As a result, more black patients had the lowest SES (SES-1) when compared to white patients (17% vs. 41%, p<0.001). When controlling for these factors by cox regression analysis, a survival disadvantage was seen in black women for both progression free survival (16 vs. 27months, p=0.003) and overall survival (42 vs. 88months, p<0.001).
Despite controlling for clinical and environmental factors, a survival disadvantage was still observed in black patients with ovarian cancer in the Deep South. Black women had lower optimal debulking rates and more platinum resistant disease. These data suggest other factors like tumor biology may play a role in racial survival differences, however, more research is needed to determine this causation.
我们的目标是评估美国南部腹地黑人卵巢癌患者的治疗和生存差异，并确定环境因素/社会经济地位（SES）如何影响生存。
对2007年至2014年的卵巢癌患者进行回顾性研究。通过美国人口普查街区数据获取社会经济地位（SES），并使用约斯特分数进行比较。采用标准统计方法进行比较。
共评估了393例患者，其中325例（83%）为白人，68例（17%）为黑人。每个种族组的人口统计学信息和手术方式相似。然而，与白人相比，黑人患者达到最佳减瘤的比例较低[分别为89%和71%（p=0.001）]，接受腹腔内化疗的比例也较低（19%对11%，p=0.01）。黑人女性的SES参数较低，包括教育程度、收入和贫困程度。因此，与白人患者相比，更多黑人患者处于最低SES水平（SES-1）（17%对41%，p<0.001）。通过Cox回归分析控制这些因素后，黑人女性在无进展生存期（16个月对27个月，p=0.003）和总生存期（42个月对88个月，p<0.001）方面均存在生存劣势。
尽管对临床和环境因素进行了控制，但在美国南部腹地的黑人卵巢癌患者中仍观察到生存劣势。黑人女性的最佳减瘤率较低，铂耐药疾病更多。这些数据表明，肿瘤生物学等其他因素可能在种族生存差异中起作用，然而，需要更多研究来确定这种因果关系。
