Department of Neurosurgery Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
J Neurooncol. 2024 Sep;169(3):457-467. doi: 10.1007/s11060-024-04748-6. Epub 2024 Jun 19.
A systematic review was conducted to investigate differences in incidence and primary origin of synchronous brain metastasis (sBM) in varying racial groups with different primary cancers.
Adhering to PRISMA 2020 guidelines a search was conducted using PubMed and Ovid databases for publications from January 2000 to January 2023, with search terms including combinations of "brain metastasis," "race," "ethnicity," and "incidence." Three independent reviewers screened for inclusion criteria encompassing studies clearly reporting primary cancer sites, patient demographics including race, and synchronous BM (sBM) incidence.
Of 806 articles, 10 studies comprised of mainly adult patients from the United States met final inclusion for data analysis. Higher sBM incidence proportions were observed in American Indian/Alaska native patients for primary breast (p < 0.001), colorectal (p = 0.015), and esophageal cancers (p = 0.024) as well as in Asian or Pacific islanders for primary stomach (p < 0.001), thyroid (p = 0.006), and lung/bronchus cancers (p < 0.001) yet higher proportions in White patients for malignant melanoma (p < 0.001). Compared to White patients, Black patients had higher sBM incidence likelihood in breast cancer (OR = 1.27, p = 0.01) but lower likelihood in renal (OR = 0.46, p < 0.001) and esophageal cancers (OR = 0.31, p = 0.005). American Indian/Alaska native patients had a higher sBM likelihood (OR = 3.78, p = 0.004) relative to White patients in esophageal cancer.
These findings reveal several comparative racial differences in sBM incidence arising from different primary cancer origins, underscoring a need for further research to explain these variations. Identifying the factors contributing to these disparities holds the potential to promote greater equity in oncological care according to cancer type.
本系统评价旨在研究不同原发癌种的不同种族人群中脑转移瘤（sBM）的发生率和原发来源的差异。
根据 PRISMA 2020 指南，我们使用 PubMed 和 Ovid 数据库进行了搜索，检索词包括“脑转移”、“种族”、“民族”和“发生率”的组合。三位独立的评审员筛选出符合纳入标准的研究，这些研究明确报告了原发癌部位、患者人口统计学信息（包括种族）和同步脑转移瘤（sBM）的发生率。
在 806 篇文章中，有 10 项主要来自美国的成人患者的研究最终符合数据分析的纳入标准。美国印第安人/阿拉斯加原住民患者的乳腺癌（p < 0.001）、结直肠癌（p = 0.015）和食管癌（p = 0.024）、亚洲或太平洋岛民患者的胃癌（p < 0.001）、甲状腺癌（p = 0.006）和肺癌/支气管癌（p < 0.001）的 sBM 发生率比例较高，而白人患者的恶性黑色素瘤（p < 0.001）的比例较高。与白人患者相比，黑人患者乳腺癌的 sBM 发生率更高（OR = 1.27，p = 0.01），但肾癌（OR = 0.46，p < 0.001）和食管癌（OR = 0.31，p = 0.005）的发生率更低。与白人患者相比，美国印第安人/阿拉斯加原住民患者的食管癌 sBM 发生率更高（OR = 3.78，p = 0.004）。
这些发现揭示了不同原发癌种来源的脑转移瘤发生率的几个比较性种族差异，这突显了进一步研究这些差异的必要性。确定导致这些差异的因素有可能根据癌症类型促进肿瘤治疗的更大公平性。
