Department of Surgery, Cooper University Hospital, Camden, NJ, USA.
Cooper Medical School of Rowan University, Camden, NJ, USA.
Ann Surg Oncol. 2024 Dec;31(13):8699-8711. doi: 10.1245/s10434-024-16168-x. Epub 2024 Sep 11.
Gallbladder cancer (GBC) is associated with a high mortality rate. Asian American (AsA) are among the fastest-growing populations in the United States, yet little is known about the disparity of GBC within this cohort. This study identified trends in treatment and outcomes for GBC in a disaggregated fashion, specifically for this population.
A retrospective analysis of the National Cancer Database (NCDB) between 2010 and 2019 examining all patients treated for gallbladder cancer was performed. Basic demographic factors were identified for patients of Caucasian, African American, and disaggregated Asian subpopulations. Survival curves were used to identify differences in median overall survival, and a multivariate analysis was performed to determine which factors impact overall survival.
A total of 1317 (5%) patients were of AsA origin. Median survival for the overall AsA population is 15.1 months compared with Caucasian (11.5 months) and African Americans (11.4 months) (p < 0.0001). Within the AsA groups, the Korean subpopulation had the lowest survival at 12.6 months, whereas Filipinos had the longest survival at 19.1 months (p < 0.0001). Patients of Filipino descent had the highest rate of surgical resection but lower chemotherapy utilization. Conversely, Korean patients had the highest utilization of multimodality therapy. Multivariate analysis demonstrated that belonging to Chinese, Filipino, or Indian ethnicity was associated with decreased risk of mortality.
There are disparate differences in survival for patients with GBC between AsA groups. Socioeconomic, genetic, and epigenetic factors may influence these differences. Further research is needed to delineate the causes of this disparity.
胆囊癌（GBC）死亡率较高。亚裔美国人（AsA）是美国增长最快的人群之一，但对于这一人群中 GBC 的差异知之甚少。本研究以分解的方式确定了 GBC 在这一人群中的治疗和结果趋势。
对 2010 年至 2019 年国家癌症数据库（NCDB）进行回顾性分析，研究了所有接受胆囊癌治疗的患者。确定了白种人、非裔美国人和亚裔亚群患者的基本人口统计学因素。使用生存曲线来确定中位总生存期的差异，并进行多变量分析以确定哪些因素影响总生存期。
共有 1317 名（5%）患者为 AsA 原籍。总体 AsA 人群的中位生存期为 15.1 个月，而白种人（11.5 个月）和非裔美国人（11.4 个月）的中位生存期为 11.5 个月（p < 0.0001）。在 AsA 人群中，韩国亚群的生存率最低，为 12.6 个月，而菲律宾人的生存率最高，为 19.1 个月（p < 0.0001）。菲律宾裔患者的手术切除率最高，但化疗使用率较低。相反，韩国患者的多模式治疗使用率最高。多变量分析表明，属于华裔、菲律宾裔或印度裔与降低死亡率的风险相关。
不同的 GBC 患者在 AsA 人群之间存在生存差异。社会经济、遗传和表观遗传因素可能影响这些差异。需要进一步研究来阐明这种差异的原因。
