Department of Upper Gastrointestinal and Hepatobiliary Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
RPA Institute of Academic Surgery, Sydney, New South Wales, Australia.
ANZ J Surg. 2024 Oct;94(10):1723-1731. doi: 10.1111/ans.19172. Epub 2024 Jul 23.
Socioeconomic status (SES) affects outcomes following surgery for various cancers. There are currently no Australian studies that examine the role of socioeconomic disadvantage on outcomes following oesophagectomy for cancer. This study assessed whether SES was associated with short-term perioperative morbidity, long-term survival, and oncological outcomes following oesophagectomy across three tertiary oesophageal cancer centres in Australia.
A retrospective cohort study was performed comprising all patients who underwent oesophagectomy for cancer across three Australian centres. Patients were stratified into SES groups using the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD). Outcomes measured included perioperative complication rates, overall survival, and disease-free survival.
The study cohort was 462 patients, 205 in the lower SES and 257 in the higher SES groups. The lower SES group presented with more advanced oesophageal cancer stage, a higher rate of T3 (52.6% versus 42.7%, P = 0.038) and N2 disease (19.6% versus 10.5%, P = 0.006), and had a higher rate of readmission within 30 days (11.2% versus 5.4%, P = 0.023). There was no difference in overall survival or disease-free survival between groups.
Lower socioeconomic status was associated with more advanced stage and increased risk of early, unplanned readmission following oesophagectomy, but was not associated with a difference in overall or disease-free survival.
社会经济地位(SES)会影响各种癌症手术后的结果。目前,澳大利亚尚无研究探讨社会经济劣势对澳大利亚三家三级食管癌中心食管癌手术后短期围手术期发病率、长期生存和肿瘤学结果的影响。本研究评估了 SES 是否与澳大利亚三家三级食管癌中心接受食管癌切除术的患者的短期围手术期发病率、长期生存和肿瘤学结果相关。
进行了一项回顾性队列研究,纳入了所有在澳大利亚三家中心接受食管癌切除术的癌症患者。使用相对社会经济优势和劣势指数(IRSAD)将患者分层为 SES 组。测量的结果包括围手术期并发症发生率、总生存率和无病生存率。
研究队列包括 462 例患者,低 SES 组 205 例,高 SES 组 257 例。低 SES 组表现为更晚期的食管癌,T3 期(52.6%比 42.7%,P=0.038)和 N2 期(19.6%比 10.5%,P=0.006)疾病的发生率更高,并且 30 天内再入院的发生率更高(11.2%比 5.4%,P=0.023)。两组之间的总生存率或无病生存率无差异。
较低的社会经济地位与更晚期的疾病阶段和更高的食管癌手术后早期、计划外再入院风险相关,但与总生存率或无病生存率无差异相关。