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基于美国监测、流行病学和最终结果数据库的儿科脑肿瘤患者的种族/民族差异与生存情况。

Racial/Ethnic Disparities and Survival in Pediatrics with Gliomas Based on the Surveillance, Epidemiology, and End Results Database in the United States.

机构信息

Department of Biochemistry and Molecular Biology, College of Basic Medical, Navy Medical University, Shangha, P.R. China.

Department of Pathology and Pathophysiology, Soochow University Medical School, Suzhou, P.R. China.

出版信息

World Neurosurg. 2020 Sep;141:e524-e529. doi: 10.1016/j.wneu.2020.05.224. Epub 2020 May 31.

Abstract

BACKGROUND

Gliomas are the most common type of primary central nervous system tumor for both children and adults. However, the influence of racial/ethnic disparities on the survival of children with gliomas has not been fully evaluated yet.

METHODS

Baseline characteristics of patients, including sex, year of diagnosis, surgery, grade, radiation, histology, and races, were collected. Univariate and multivariate analyses for overall survival (OS) were performed using Cox proportional hazards regression model. Survival curves were plotted using Kaplan-Meier methods.

RESULTS

A total of 4400 childhood patients were enrolled, including 2516 non-Hispanic whites (NHWs), 1050 Hispanic whites (HWs), 519 blacks, 282 Asians or Pacific Islanders (APIs), and 33 American Indian/Alaska Natives. NHWs had the longest overall survival (OS), whereas blacks had the shortest OS (P = 0.003). Stratified by histologic type, OS of children with astrocytoma was better among NHWs and HWs than among blacks and APIs (P = 0.004). OS of children with ependymoma was better among NHWs and APIs than among HWs and blacks (P = 0.008). However, no significant difference was observed in OS for children with medulloblastoma (P = 0.854).

CONCLUSIONS

Survival outcomes varied significantly by race/ethnicity among childhood gliomas. Better management of childhood gliomas is warranted to close the survival gap between race/ethnicity.

摘要

背景

神经胶质瘤是儿童和成人中枢神经系统原发性肿瘤中最常见的类型。然而,种族/民族差异对儿童神经胶质瘤患者生存的影响尚未得到充分评估。

方法

收集患者的基线特征,包括性别、诊断年份、手术、分级、放疗、组织学和种族。使用 Cox 比例风险回归模型对总生存期(OS)进行单因素和多因素分析。使用 Kaplan-Meier 方法绘制生存曲线。

结果

共纳入 4400 例儿童患者,包括 2516 例非西班牙裔白人(NHW)、1050 例西班牙裔白人(HW)、519 例黑人、282 例亚洲人或太平洋岛民(API)和 33 例美洲印第安人/阿拉斯加原住民。NHW 的总体生存时间最长,而黑人的总体生存时间最短(P=0.003)。按组织学类型分层,NHW 和 HW 儿童的星形细胞瘤 OS 优于黑人和 API(P=0.004)。NHW 和 API 儿童的室管膜瘤 OS 优于 HW 和黑人(P=0.008)。然而,髓母细胞瘤患儿的 OS 无显著差异(P=0.854)。

结论

儿童神经胶质瘤的生存结果因种族/民族而异。需要更好地管理儿童神经胶质瘤,以缩小种族/民族之间的生存差距。

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