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比较国际转移性肾细胞癌数据库中晚期肾细胞癌的西班牙裔和非西班牙裔患者的结局。

Comparison of outcomes for Hispanic and non-Hispanic patients with advanced renal cell carcinoma in the International Metastatic Renal Cell Carcinoma Database.

机构信息

University of California, San Diego Health, La Jolla, California, USA.

Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

出版信息

Cancer. 2024 Jun 1;130(11):2003-2013. doi: 10.1002/cncr.35216. Epub 2024 Jan 31.

Abstract

BACKGROUND

Existing data on the impact of Hispanic ethnicity on outcomes for patients with renal cell carcinoma (RCC) is mixed. The authors investigated outcomes of Hispanic and non-Hispanic White (NHW) patients with advanced RCC receiving systemic therapy at large academic cancer centers using the International Metastatic Renal Cell Carcinoma Database (IMDC).

METHODS

Eligible patients included non-Black Hispanic and NHW patients with locally advanced or metastatic RCC initiating systemic therapy. Overall survival (OS) and time to first-line treatment failure (TTF) were calculated using the Kaplan-Meier method. The effect of ethnicity on OS and TTF were estimated by Cox regression hazard ratios (HRs).

RESULTS

A total of 1563 patients (181 Hispanic and 1382 NHW) (mostly males [73.8%] with clear cell RCC [81.5%] treated with tyrosine kinase inhibitor [TKI] monotherapy [69.9%]) were included. IMDC risk groups were similar between groups. Hispanic patients were younger at initial diagnosis (median 57 vs. 59 years, p = .015) and less likely to have greater than one metastatic site (60.8% vs. 76.8%, p < .001) or bone metastases (23.8% vs. 33.4%, p = .009). Median OS and TTF was 38.0 months (95% confidence interval [CI], 28.1-59.2) versus 35.7 months (95% CI, 31.9-39.2) and 7.8 months (95% CI, 6.2-9.0) versus 7.5 months (95% CI, 6.9-8.1), respectively, in Hispanic versus NHW patients. In multivariable Cox regression analysis, no statistically significant differences were observed in OS (adjusted hazard ratio [HR], 1.07; 95% CI, 0.86-1.31, p = .56) or TTF (adjusted HR, 1.06; 95% CI, 0.89-1.26, p = .50).

CONCLUSIONS

The authors did not observe statistically significant differences in OS or TTF between Hispanic and NHW patients with advanced RCC. Receiving treatment at tertiary cancer centers may mitigate observed disparities in cancer outcomes.

摘要

背景

现有数据表明,西班牙裔族群对肾细胞癌(RCC)患者的影响结果存在差异。作者使用国际转移性肾细胞癌数据库(IMDC),调查了在大型学术癌症中心接受系统治疗的晚期 RCC 西班牙裔和非西班牙裔白人(NHW)患者的结局。

方法

符合条件的患者包括局部晚期或转移性 RCC 初治患者,接受系统治疗。使用 Kaplan-Meier 法计算总生存期(OS)和一线治疗失败时间(TTF)。使用 Cox 回归风险比(HR)估计种族对 OS 和 TTF 的影响。

结果

共纳入 1563 例患者(181 例西班牙裔和 1382 例 NHW)(大多数为男性[73.8%],透明细胞 RCC[81.5%],接受酪氨酸激酶抑制剂[TKI]单药治疗[69.9%])。两组间 IMDC 风险组相似。西班牙裔患者的初始诊断年龄较小(中位数 57 岁比 59 岁,p=0.015),且转移部位大于一处(60.8%比 76.8%,p<0.001)或有骨转移(23.8%比 33.4%,p=0.009)的可能性较低。西班牙裔患者的中位 OS 和 TTF 分别为 38.0 个月(95%CI,28.1-59.2)和 7.8 个月(95%CI,6.2-9.0),而 NHW 患者分别为 35.7 个月(95%CI,31.9-39.2)和 7.5 个月(95%CI,6.9-8.1)。多变量 Cox 回归分析显示,OS(调整后的 HR,1.07;95%CI,0.86-1.31,p=0.56)或 TTF(调整后的 HR,1.06;95%CI,0.89-1.26,p=0.50)无统计学差异。

结论

作者未观察到西班牙裔和 NHW 晚期 RCC 患者的 OS 或 TTF 存在统计学差异。在三级癌症中心接受治疗可能会减轻癌症结局方面的观察到的差异。

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