Kim Jason D, Chang Jennifer T, Moghaddamjou Ali, Kornelsen Emily A, Ruan Jenny Y, Olson Robert A, Cheung Winson Y
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Department of Oncology, University of Calgary, Tom Baker Cancer Center, Calgary, Alberta, Canada.
Laryngoscope. 2017 Nov;127(11):2528-2533. doi: 10.1002/lary.26603. Epub 2017 Apr 11.
OBJECTIVES/HYPOTHESIS: To evaluate disparities in overall survival (OS) between Asian and non-Asian patients diagnosed with non-nasopharyngeal head and neck cancer (HNC).
This was a population-based, retrospective study of patients diagnosed with non-nasopharyngeal HNC of squamous cell carcinoma histology between 2001 and 2010 in British Columbia, Canada.
Using Kaplan-Meier methods and Cox regression models, we examined the relationship between race and OS.
A total of 3,036 patients were included in the study. Median age was 64 years, 74% were men, and 7% were Asians. Asians had worse Eastern Cooperative Oncology Group (ECOG) status (29% vs. 23%, P = .07) and larger tumors (33% vs. 21%, P = .02), and were more likely to be diagnosed with oral cavity cancers (38% vs. 25%, P < .001) than non-Asians. Asians were also less likely to receive multimodality therapy than non-Asians (90% vs. 95%, P = .02). Asians were more likely to have never smoked (49% vs. 15%, P < .001) and to be married or with a partner (80% vs. 69%, P = .02). Multivariate models showed that Asians had better OS than non-Asians (hazard ratio [HR] = 0.50, 95% confidence interval [CI] = 0.25-0.99, P = .05). Three-year OS did not differ significantly between Asians and non-Asians (41% vs. 42%, P = .18); however, 5-year OS did (22% vs. 19% P = .03). Stratifying by treatment type, outcomes were comparable in both groups except for radiotherapy alone, where Asians showed significantly better OS (HR = 0.71, 95% CI = 0.51-0.99, P = .04). Advanced age, worse ECOG, greater tumor size, and lack of treatment also correlated with inferior OS.
Despite several worse prognostic features and less aggressive treatment, Asians tended to exhibit better OS than non-Asians.
2c. Laryngoscope, 127:2528-2533, 2017.
目的/假设：评估被诊断为非鼻咽癌的头颈癌（HNC）的亚洲患者与非亚洲患者在总生存期（OS）方面的差异。
这是一项基于人群的回顾性研究，研究对象为2001年至2010年在加拿大不列颠哥伦比亚省被诊断为组织学类型为鳞状细胞癌的非鼻咽癌的患者。
我们使用Kaplan-Meier方法和Cox回归模型来研究种族与总生存期之间的关系。
共有3036名患者纳入本研究。中位年龄为64岁，74%为男性，7%为亚洲人。亚洲人的东部肿瘤协作组（ECOG）状态较差（29%对23%，P = 0.07），肿瘤较大（33%对21%，P = 0.02），且与非亚洲人相比，更有可能被诊断为口腔癌（38%对25%，P < 0.001）。与非亚洲人相比，亚洲人接受多模式治疗的可能性也较小（90%对95%，P = 0.02）。亚洲人更有可能从不吸烟（49%对15%，P < 0.001），且已婚或有伴侣（80%对69%，P = 0.02）。多变量模型显示，亚洲人的总生存期优于非亚洲人（风险比[HR] = 0.50，95%置信区间[CI] = 0.25 - 0.99, P = 0.05）。亚洲人和非亚洲人的三年总生存期无显著差异（41%对42%，P = 0.18）；然而，五年总生存期有差异（22%对19%，P = 0.03）。按治疗类型分层，除单纯放疗外，两组的结局相当，在单纯放疗中，亚洲人的总生存期显著更好（HR = 0.71，95% CI = 0.51 - 0.99，P = 0.04）。高龄、较差的ECOG状态、更大的肿瘤大小以及未接受治疗也与较差的总生存期相关。
尽管有几个预后较差的特征且治疗积极性较低，但亚洲人的总生存期往往优于非亚洲人。
2c。《喉镜》，127:2528 - 2533，2017年。
