Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
J Surg Res. 2024 Nov;303:322-331. doi: 10.1016/j.jss.2024.09.037. Epub 2024 Oct 12.
In this study, we evaluate the association between sociodemographics and disease presentation, treatment, and survival for children, adolescents, and young adults with Ewing sarcoma.
Case-level data were downloaded from The Surveillance, Epidemiology, and End Results database. Cases included patients ages 0-24 who were diagnosed with Ewing sarcoma between 2004 and 2020.
One thousand two hundred forty four patients were included in the analysis. When compared to non-Hispanic White (NHW) patients, Hispanic patients were more likely to present with tumors ≥8 cm (odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.24-2.36) and metastases (OR = 1.65, 95% CI = 1.23-2.20). Black patients were less likely to receive chemotherapy (OR = 0.25, 95% CI = 0.07-0.97). The 5-year disease-specific survival rate was 73% for NHW patients, 65% for Black patients, 67% for Asian patients and 66% for Hispanic patients. When accounting for confounding factors, Hispanic and Asian patients had higher probabilities of death due to cancer compared to NHW patients (HR = 1.41, 95% CI = 1.10-1.81; HR = 1.64, 95% CI = 1.09-2.48, respectively). Young adults and adolescents were significantly more likely to present with metastases, experience ≥1 month between diagnosis and treatment, and had lower survival.
Significant differences in Ewing sarcoma presentation, treatment, and survival were observed across age groups and race/ethnicity. Future work should focus on expanding access to care in underserved groups. Further qualitative studies could assist in determining the exact factors that prevent patients from accessing care or examine how genetic factors that contribute to Ewing sarcoma severity differ across demographic groups.
本研究评估了社会人口统计学因素与儿童、青少年和青年尤文肉瘤患者的疾病表现、治疗和生存之间的关系。
从监测、流行病学和最终结果数据库中下载病例级别的数据。纳入的病例为 2004 年至 2020 年间诊断为尤文肉瘤的 0-24 岁患者。
本研究共纳入 1244 例患者。与非西班牙裔白人（NHW）患者相比，西班牙裔患者更有可能出现肿瘤直径≥8cm（比值比（OR）=1.71，95%置信区间（CI）=1.24-2.36）和转移（OR=1.65，95%CI=1.23-2.20）。黑人患者接受化疗的可能性较小（OR=0.25，95%CI=0.07-0.97）。NHW 患者的 5 年疾病特异性生存率为 73%，黑人患者为 65%，亚裔患者为 67%，西班牙裔患者为 66%。在考虑混杂因素后，与 NHW 患者相比，西班牙裔和亚裔患者因癌症死亡的概率更高（HR=1.41，95%CI=1.10-1.81；HR=1.64，95%CI=1.09-2.48）。青少年和青年患者更有可能出现转移，诊断和治疗之间的时间间隔≥1 个月，生存率更低。
在年龄组和种族/民族之间，尤文肉瘤的表现、治疗和生存存在显著差异。未来的工作应重点关注扩大服务不足群体获得医疗服务的机会。进一步的定性研究可以帮助确定阻止患者获得医疗服务的确切因素，或者研究导致尤文肉瘤严重程度在不同人群中存在差异的遗传因素。
