Division of Otolaryngology-Head and Neck Surgery, Hofstra Northwell School of Medicine, Staten Island, New York.
Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
Cancer. 2018 Apr 15;124(8):1780-1790. doi: 10.1002/cncr.31252. Epub 2018 Feb 6.
Anaplastic thyroid cancer (ATC) is the rarest type of thyroid cancer and has the lowest overall survival. To the authors' knowledge, the impact of socioeconomic status and race/ethnicity has not yet been described.
Data regarding 719 patients diagnosed with their first primary malignant ATC from January 1, 1998 to December 31, 2011 in the Surveillance, Epidemiology, and End Results program registries were examined. Differences in receipt of thyroidectomy, radiotherapy, and lymph node examination were examined by race/ethnicity. Survival also was examined by race/ethnicity.
Nearly 70% of patients were non-Hispanic white, and 55.4% of patients received treatment. Tumor size (P = .13), lymph node involvement (P = .60), and residence in high poverty neighborhoods (P = .08) did not vary by race/ethnicity. Nonwhite patients were more likely to receive no treatment (adjusted odds ratio, 0.29; 95% confidence interval [95% CI], 0.16-0.54). When receipt of radiotherapy was adjusted for, nonwhite patients had a higher risk of overall death (adjusted hazards ratio [aHR], 1.24; 95% CI, 1.01-1.54), although not disease-specific death (aHR, 1.14; 95% CI, 0.92-1.42). Patients living in areas of high poverty had lower overall survival (aHR, 1.54; 95% CI, 1.09-2.18) and disease-specific survival (aHR, 1.68; 95% CI, 1.19-2.36).
In this population-based study of patients with ATC, nonwhite patients were found to be less likely to receive treatment. Furthermore, nonwhite patients had poorer overall survival, and patients living in areas of high poverty had both worse overall and disease-specific survival. Racial/ethnic and socioeconomic disparities appear to exist in the treatment and survival of patients with ATC. Cancer 2018;124:1780-90. © 2018 American Cancer Society.
间变性甲状腺癌（ATC）是甲状腺癌中最罕见的类型，总生存率最低。据作者所知，社会经济地位和种族/民族的影响尚未描述。
检查了 1998 年 1 月 1 日至 2011 年 12 月 31 日期间在监测、流行病学和最终结果（SEER）计划登记处诊断为首次原发性恶性 ATC 的 719 名患者的数据。根据种族/民族检查甲状腺切除术、放疗和淋巴结检查的差异。还根据种族/民族检查了生存情况。
近 70%的患者为非西班牙裔白人，55.4%的患者接受了治疗。肿瘤大小（P=0.13）、淋巴结受累（P=0.60）和居住在高贫困社区（P=0.08）与种族/民族无关。非白人患者更有可能不接受治疗（调整后的优势比，0.29；95%置信区间[95%CI]，0.16-0.54）。当调整放疗的接受情况时，非白人患者的总死亡风险更高（调整后的危害比[aHR]，1.24；95%CI，1.01-1.54），尽管疾病特异性死亡（aHR，1.14；95%CI，0.92-1.42）没有增加。居住在高贫困地区的患者总体生存率较低（aHR，1.54；95%CI，1.09-2.18）和疾病特异性生存率（aHR，1.68；95%CI，1.19-2.36）。
在这项基于人群的 ATC 患者研究中，发现非白人患者接受治疗的可能性较低。此外，非白人患者的总体生存率较差，居住在高贫困地区的患者总体生存率和疾病特异性生存率均较差。在 ATC 患者的治疗和生存方面似乎存在种族/民族和社会经济差异。癌症 2018;124:1780-90。©2018 美国癌症协会。
