在髓样甲状腺癌的表现和治疗方面存在性别差异和种族/民族差异。
Sex differences and racial/ethnic disparities in the presentation and treatment of medullary thyroid cancer.
机构信息
Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA; Penn Center for Cancer Care Innovation, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA.
出版信息
Am J Surg. 2024 Aug;234:19-25. doi: 10.1016/j.amjsurg.2024.02.009. Epub 2024 Feb 8.
BACKGROUND
This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC).
METHODS
Patients with MTC (2010-2020) were identified from the National Cancer Database. Differences in disease presentation and likelihood of guideline-concordant surgical management (total thyroidectomy and resection of ≥1 lymph node) were assessed by sex and race/ethnicity.
RESULTS
Of 6154 patients, 68.2% underwent guideline-concordant surgery. Tumors >4 cm were more likely in men (vs. women: OR 2.47, p < 0.001) and Hispanic patients (vs. White patients: OR 1.52, p = 0.001). Non-White patients were more likely to have distant metastases (Black: OR 1.63, p = 0.002; Hispanic: OR 1.44, p = 0.038) and experienced longer time to surgery (Black: HR 0.66, p < 0.001; Hispanic: HR 0.71, p < 0.001). Black patients were less likely to undergo guideline-concordant surgery (OR 0.70, p = 0.022).
CONCLUSIONS
Male and non-White patients with MTC more frequently present with advanced disease, and Black patients are less likely to undergo guideline-concordant surgery.
背景
本研究评估了甲状腺髓样癌（MTC）在表现和治疗上的差异。
方法
从国家癌症数据库中确定了 2010 年至 2020 年期间患有 MTC 的患者。通过性别和种族/民族评估疾病表现和符合指南的手术管理（甲状腺全切除术和切除≥1 个淋巴结）的可能性差异。
结果
在 6154 名患者中，68.2%接受了符合指南的手术。男性（与女性相比：OR 2.47，p<0.001）和西班牙裔患者（与白人患者相比：OR 1.52，p=0.001）的肿瘤>4 厘米的可能性更高。非白人患者更有可能发生远处转移（黑人：OR 1.63，p=0.002；西班牙裔：OR 1.44，p=0.038），并且手术时间更长（黑人：HR 0.66，p<0.001；西班牙裔：HR 0.71，p<0.001）。黑人患者接受符合指南的手术的可能性较低（OR 0.70，p=0.022）。
结论
患有 MTC 的男性和非白人患者更常出现晚期疾病，而黑人患者接受符合指南的手术的可能性较低。
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