Department of Urology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Department of Urology, University of Florida Health, Jacksonville, Florida, USA.
Cancer Med. 2023 Feb;12(3):3452-3459. doi: 10.1002/cam4.5124. Epub 2022 Aug 9.
To stratify 10-year survival outcomes by degree of social disparities in pediatric Wilms' tumor patients. We applied the Social Deprivation Index (SDI) to survival outcomes from the national SEER database to elucidate the effects of lower socioeconomics on cancer survival.
A retrospective cohort study was performed using the national Surveillance, Epidemiology, and End Results (SEER) oncology registry from 1975 to 2016 based on county-level data. Pediatric patients (<18 years old) with a diagnosis of WT (C64.9) and confirmed based on histology codes (8960/8963) were included. SDI scores were calculated for each patient and initially divided into quintiles. Patients were delineated into high-risk (>60th percentile/more deprived) or low-risk (<60th percentile/less deprived) groups. Statistics were assessed using Fisher's exact test, Student's t-test, and Kaplan-Meier assessed survival differences with log-rank test for trend.
A total of 3406 patients were included with 1366 patients reported in the high-risk group and 2040 patients in the low-risk group. Quintile data demonstrated a stratification in survival based on socioeconomic status. Patients in more socially deprived counties were significantly (p = 0.035) more likely to have worse overall survival compared with those living in less deprived areas at 10-year (87.3% vs 89.3%) follow-up.
10-year overall and cancer-specific survival data for patients with Wilms' tumor stratify by socioeconomic lines. This represents an area that needs to be addressed in this pediatric oncologic population. Patients from more socially deprived areas have significantly worse 10-year overall survival rates and noticeably different 10-year cancer-specific survival rates.
为了对小儿肾母细胞瘤患者的社会差异程度进行 10 年生存率分层。我们应用社会剥夺指数（SDI）对国家 SEER 数据库的生存结果进行分析，以阐明较低社会经济地位对癌症生存的影响。
对国家 SEER 肿瘤登记处 1975 年至 2016 年的县级数据进行回顾性队列研究。纳入患有 WT（C64.9）并基于组织学代码（8960/8963）确诊的儿科患者（<18 岁）。为每位患者计算 SDI 评分，并初步将其分为五分位数。将患者分为高危（>第 60 百分位/更贫困）或低危（<第 60 百分位/较不贫困）组。使用 Fisher 精确检验、Student's t 检验和 Kaplan-Meier 评估统计数据，对数秩检验用于趋势分析生存差异。
共纳入 3406 例患者，其中高危组报告 1366 例，低危组报告 2040 例。五分位数数据显示，根据社会经济地位对生存进行分层。与生活在较不贫困地区的患者相比，生活在社会资源更匮乏的县的患者总体生存率明显（p=0.035）较差，10 年（87.3% vs 89.3%）随访后。
Wilms 肿瘤患者的 10 年总生存率和癌症特异性生存率数据按社会经济线分层。这是儿科肿瘤患者中需要解决的一个领域。来自社会资源更匮乏地区的患者 10 年总生存率明显较低，10 年癌症特异性生存率也明显不同。
