University of Alabama At Birmingham, Department of General Surgery, USA.
University of Alabama At Birmingham, Department of General Surgery, USA.
Am J Surg. 2024 Aug;234:85-91. doi: 10.1016/j.amjsurg.2024.02.002. Epub 2024 Feb 27.
The influence of time to surgery on racial/ethnic disparities in papillary thyroid carcinoma (PTC) survival remains unstudied.
The National Cancer Database (2004-2017) was queried for patients with localized PTC. Survival data was compared by time to surgery, patient demographics, and multivariable Cox regression was performed.
Of 126,708 patients included, 5% were Black, 10% Hispanic. Of all patients, 85% had no comorbidities. Non-Hispanic White (NHW) patients had a shorter median time to surgery than Black and Hispanic patients (36 vs. 43 vs. 42 days, respectively p < 0.001). In multivariable analysis, longer time to surgery (>90 days vs < 30 days) and Black race vs NHW, were associated with worse survival (HR: 1.56, (95%CI, 1.43-1.70), p < 0.001 and HR: 1.21, (1.08-1.36), p = 0.001), respectively.
Delaying surgery for thyroid cancer is associated with worse survival. However, independent of time to surgery and other confounders, there remains a disparity as black patients have poorer outcomes.
手术时间对甲状腺乳头状癌（PTC）生存的种族/民族差异的影响尚未研究。
本研究通过查询国家癌症数据库（2004-2017 年），纳入局限性 PTC 患者。通过手术时间、患者人口统计学资料对生存数据进行比较，并进行多变量 Cox 回归分析。
在纳入的 126708 例患者中，5%为黑人，10%为西班牙裔。所有患者中，85%无合并症。非西班牙裔白人（NHW）患者的手术中位时间短于黑人患者和西班牙裔患者（分别为 36 天、43 天和 42 天，p<0.001）。多变量分析显示，手术时间延长（>90 天与<30 天）和黑种人比 NHW 与生存率降低相关（HR：1.56，95%CI：1.43-1.70，p<0.001 和 HR：1.21，1.08-1.36，p=0.001）。
甲状腺癌手术时间延迟与生存率降低相关。然而，无论手术时间和其他混杂因素如何，黑人患者的预后仍较差，存在差异。
