Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2018 Apr 15;124(8):1760-1769. doi: 10.1002/cncr.31241. Epub 2018 Jan 25.
Racial disparities in cancer outcomes have been described. To the authors' knowledge, it remains unclear whether patients of Hispanic ethnicity have better or worse survival outcomes. In the current study, the authors evaluated whether Hispanic participants in SWOG clinical trials had different survival outcomes compared with non-Hispanics.
Adult patients registered in SWOG phase 2/3 clinical trials between 1986 and 2012 were analyzed. Studies of similar histology and stage of disease were combined. Within each analysis, Kaplan-Meier survival curves were generated to examine differences in outcome by ethnicity. Multivariate Cox regression was used to estimate the association between ethnicity and survival outcomes, controlling for major disease-specific prognostic factors and demographic variables plus area-level income and education to account for socioeconomic status.
A total of 29,338 patients registered to 38 trials were included; 5% of these patients were Hispanic. Hispanic patients were more likely to be younger and from areas of lower income and education (all P<.05). No differences in survival were observed across tumor types except in the patients with advanced stage prostate cancer, in whom the authors observed an association between Hispanic ethnicity and worse overall survival (hazard ratio [HR], 1.40; P = .006), progression-free survival (HR, 1.36; P = .007), and cancer-specific survival (HR, 1.42; P = .013). After adjusting for multiple comparisons, no differences in outcomes were noted.
Hispanic patients participating in SWOG trials who received uniform treatment and follow-up were found to have similar survival outcomes compared with non-Hispanic patients, with the single exception of those patients with advanced stage prostate cancer. The results of the current study demonstrate that Hispanic patients receiving uniform treatment and follow-up have similar outcomes compared with non-Hispanics. Cancer 2018;124:1760-9. © 2018 American Cancer Society.
癌症结局的种族差异已被描述。据作者所知，西班牙裔患者的生存结果是否更好或更差仍不清楚。在目前的研究中，作者评估了 SWOG 临床试验中的西班牙裔参与者与非西班牙裔参与者的生存结果是否不同。
分析了 1986 年至 2012 年间在 SWOG 阶段 2/3 临床试验中登记的成年患者。将具有相似组织学和疾病分期的研究进行了合并。在每项分析中，生成 Kaplan-Meier 生存曲线，以检查种族对结果的差异。多变量 Cox 回归用于估计种族与生存结果之间的关联，控制主要疾病特异性预后因素和人口统计学变量，外加区域收入和教育水平以考虑社会经济地位。
共纳入 38 项试验的 29338 例患者；其中 5%的患者为西班牙裔。西班牙裔患者更年轻，来自收入和教育水平较低的地区（均 P<.05）。除晚期前列腺癌患者外，不同肿瘤类型的生存情况无差异，作者观察到西班牙裔与总体生存（风险比[HR]，1.40；P =.006）、无进展生存（HR，1.36；P =.007）和癌症特异性生存（HR，1.42；P =.013）之间存在关联。在进行多次比较调整后，未发现结局存在差异。
在接受统一治疗和随访的 SWOG 试验中，西班牙裔患者的生存结果与非西班牙裔患者相似，唯一的例外是晚期前列腺癌患者。目前的研究结果表明，接受统一治疗和随访的西班牙裔患者与非西班牙裔患者的结局相似。癌症 2018；124：1760-9. ©2018 美国癌症协会。
