Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA; Newton-Wellesley Hospital, 2014 Washington Street, Newton, MA, 02462, USA.
Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
Am J Surg. 2020 Oct;220(4):952-957. doi: 10.1016/j.amjsurg.2020.02.019. Epub 2020 Feb 21.
We hypothesized that differences in resection rates of colorectal liver metastases exist based on socioeconomic status (SES) inequalities.
The NCDB was utilized to study patients of different median household income diagnosed with colon adenocarcinoma from 2010 to 2015.
A total of 21,258 patients met inclusion criteria, of whom 3,587 (16.9%) underwent metastasectomy. Patients of the highest income quartile were more likely to undergo metastasectomy compared to the lowest quartile (OR 1.20, CI 1.07-1.37, p = 0.003). Overall, patients in the highest income quartile had a median OS of 17.1 months compared with 13.0 months for the lowest quartile (HR 0.85, CI 0.81-0.90, p < 0.001). While metastasectomy was associated with improved OS across all groups, the disparity by income quartile widened (29.2 vs. 22.0 months, respectively; HR 0.51, CI 0.49-0.54, p < 0.001).
Higher income patients were more likely to undergo metastasectomy compared with lower income patients and were associated with longer OS.
我们假设，结直肠肝转移的切除率存在社会经济地位（SES）不平等的差异。
利用 NCDB 研究了 2010 年至 2015 年间不同家庭收入中位数诊断为结肠癌腺癌的患者。
共有 21258 名患者符合纳入标准，其中 3587 名（16.9%）接受了转移切除术。与收入最低的四分位数相比，收入最高的四分位数患者更有可能接受转移切除术（OR 1.20，CI 1.07-1.37，p=0.003）。总体而言，收入最高四分位数的患者中位 OS 为 17.1 个月，而收入最低四分位数的患者为 13.0 个月（HR 0.85，CI 0.81-0.90，p<0.001）。虽然转移切除术与所有组的 OS 改善相关，但按收入四分位数的差异扩大（分别为 29.2 个月和 22.0 个月；HR 0.51，CI 0.49-0.54，p<0.001）。
与低收入患者相比，高收入患者更有可能接受转移切除术，并且与更长的 OS 相关。
