手术时间差异对甲状腺癌生存的种族影响。
Racial implications of time to surgery in disparities in thyroid cancer survival.
机构信息
University of Alabama At Birmingham, Department of General Surgery, USA.
University of Alabama At Birmingham, Department of General Surgery, USA.
出版信息
Am J Surg. 2024 Aug;234:85-91. doi: 10.1016/j.amjsurg.2024.02.002. Epub 2024 Feb 27.
INTRODUCTION
The influence of time to surgery on racial/ethnic disparities in papillary thyroid carcinoma (PTC) survival remains unstudied.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
简介
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。
材料与方法
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。
结果
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）。
结论
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。
Zotero 插件