鼻腔神经外胚层瘤患者生存的地理和社会经济因素分析

Geographic and Socioeconomic Factors on Survival in Esthesioneuroblastoma.

机构信息

Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, U.S.A.

Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.

出版信息

Laryngoscope. 2021 Jul;131(7):E2162-E2168. doi: 10.1002/lary.29228. Epub 2020 Dec 21.

DOI:10.1002/lary.29228

PMID:33347619

Abstract

OBJECTIVES

Esthesioneuroblastoma (ENB) is a rare sinonasal malignancy with little known regarding how regional and socioeconomic differences in the United States alter disease survival. The aim of this study is to explore the geographic difference in clinical features, socioeconomic factors, and survival outcomes of ENB patients.

METHODS

ENB cases were extracted from the Surveillance, Epidemiology, and End Results registry from 1975-2016. Patient data were stratified based on geographical location and comparative analyses of socioeconomic features, disease characteristics, and survival patterns were performed. Kaplan-Meier regression analyses were used to estimate disease-specific survival (DSS).

RESULTS

A total of 987 patients were identified: 56.4% West, 14.0% South, 12.7% Midwest, and 16.6% East. The West had the highest proportion of patients with Medicaid coverage (P < .001), stage A malignancy (P < .001), and treated with surgery and adjuvant radiotherapy (P < .001). The South had the highest proportion of patients who were Black (P < .001), uninsured (P < .001), and resided in rural areas (P < .001). Five-year DSS patterns were 81.0% (West), 79.8% (East), 67.4% (Midwest), and 72.7% (South) [P = .018]. Ten-year DSS outcomes were 74.0% (West), 73.7% (East), 60.9% (Midwest), and 63.6% (South) [P = .017].

CONCLUSION

In ENB patients, survival disparity exists in the United States based on geographical region. Patients from the West and East exhibit higher survival than those from the South and Midwest.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:E2162-E2168, 2021.

摘要

目的

嗅神经母细胞瘤（ENB）是一种罕见的鼻腔鼻窦恶性肿瘤，关于美国地区和社会经济差异如何改变疾病的生存情况知之甚少。本研究旨在探讨 ENB 患者的临床特征、社会经济因素和生存结果的地理差异。

方法

从 1975 年至 2016 年，从监测、流行病学和最终结果登记处提取 ENB 病例。根据地理位置对患者数据进行分层，并对社会经济特征、疾病特征和生存模式进行比较分析。采用 Kaplan-Meier 回归分析估计疾病特异性生存率（DSS）。

结果

共确定了 987 例患者：56.4%来自西部，14.0%来自南部，12.7%来自中西部，16.6%来自东部。西部患者中有医疗补助保险（Medicaid）覆盖的比例最高（P < .001），处于 A 期恶性肿瘤的比例最高（P < .001），接受手术和辅助放疗的比例也最高（P < .001）。南部患者中黑人（P < .001）、无保险（P < .001）和居住在农村地区（P < .001）的比例最高。5 年 DSS 模式分别为 81.0%（西部）、79.8%（东部）、67.4%（中西部）和 72.7%（南部）[P = .018]。10 年 DSS 结果分别为 74.0%（西部）、73.7%（东部）、60.9%（中西部）和 63.6%（南部）[P = .017]。