Whitrock Jenna N, Carter Michela M, Pratt Catherine G, Brokamp Cole, Harvey Krysten, Pan Jianmin, Rai Shesh, Salfity Hai, Starnes Sandra L, Van Haren Robert M
Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Ann Thorac Surg Short Rep. 2024 Jun 28;2(4):618-623. doi: 10.1016/j.atssr.2024.06.010. eCollection 2024 Dec.
Socioeconomic status and pollution exposure have been described as risk factors for poor survival in patients with non-small cell lung cancer (NSCLC). However, the relationship between these factors is complex and inadequately studied. This study aimed to evaluate the relationship between environmental and social factors and their impact on survival after NSCLC resection.
A prospective database for all patients with NSCLC who underwent primary resection from 2006 to 2021 was analyzed. Ambient fine particulate matter (air pollution smaller than 2.5 μm [PM]), greenness, and deprivation index (a measure of neighborhood-level material deprivation composed of 6 factors) were linked to individual patients by geocoding their residential address.
A total of 661 patients who underwent pulmonary resection for NSCLC were evaluated. Black patients had increased levels of community deprivation compared with White patients; however, there was no difference in PM exposure or overall survival between races. Increased PM exposure was an independent predictor of worse survival on univariable and multivariable analysis (hazard ratio, 1.06; = .003).
Increased PM exposure is associated with worse overall survival in resected NSCLC and was a more significant factor than race and material deprivation in this population. Interventions to reduce environmental air pollution could improve lung cancer survival.
社会经济地位和接触污染已被描述为非小细胞肺癌（NSCLC）患者生存不良的风险因素。然而，这些因素之间的关系复杂且研究不足。本研究旨在评估环境和社会因素之间的关系及其对NSCLC切除术后生存的影响。
分析了2006年至2021年所有接受初次切除的NSCLC患者的前瞻性数据库。通过对患者居住地址进行地理编码，将环境细颗粒物（小于2.5μm的空气污染[PM]）、绿化程度和贫困指数（一种由6个因素组成的邻里层面物质匮乏衡量指标）与个体患者相关联。
共评估了661例接受NSCLC肺切除术的患者。与白人患者相比，黑人患者的社区贫困程度更高；然而，不同种族之间在PM暴露或总生存率方面没有差异。在单变量和多变量分析中，PM暴露增加是生存较差的独立预测因素（风险比，1.06；P = .003）。
PM暴露增加与切除的NSCLC患者总体生存较差相关，并且在该人群中是比种族和物质匮乏更重要的因素。减少环境空气污染的干预措施可能会改善肺癌患者的生存。
