Bassiri Aria, Hu Yue-Lin, Boutros Christina, Jiang Boxiang, Sinopoli Jillian, Vargas Leonidas Tapias, Linden Philip A, Towe Christopher W
Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
School of Medicine, Case Western Reserve University, 9501 Euclid Avenue, Cleveland, OH 44106, USA.
Medicina (Kaunas). 2025 Apr 19;61(4):753. doi: 10.3390/medicina61040753.
: Patients of Asian descent are often grouped together despite their diverse ethnicities and genetic backgrounds. Cancer outcomes result from a complex interplay of genetics, environment, and socioeconomic factors. This study aims to describe lung cancer survival outcome variations in Asian ethnic subgroups, hypothesizing that significant outcome differences exist between subgroups. : A retrospective analysis of the 2020 National Cancer Database identified patients with stage IV non-small-cell lung cancer (NSCLC). Asian patients were subcategorized into nine groups: Chinese, Japanese, Korean, Asian Indian/Pakistani, Vietnamese, Pacific Islander, Filipino, Laotian/Hmong/Kampuchean/Thai, and Other Asian/Asian not otherwise specified (NOS). The primary outcome was overall survival, and the secondary outcome was utilization of palliative care. Kaplan-Meier analysis and multivariate Cox and logistic modeling were used to assess outcomes of interest. : A total of 23,747 Asian patients with stage IV NSCLC were identified. Demographic characteristics of the subgroups varied by age, sex, Charlson-Deyo Comorbidity Index, and utilization of palliative care. Relative to Chinese Asians, multivariate Cox analysis showed worse survival outcomes among patients categorized as Japanese, Korean, Pacific Islanders, Filipino, and Laotian/Hmong/Kampuchean/Thai. The rate of palliative care utilization also varied among Asian subgroups. Compared to Chinese patients, palliative care was more likely to be utilized by patients categorized as Japanese and Pacific Islander. : Amongst Asian subgroups, variations in survival outcomes and palliative care utilization in stage IV NSCLC patients were observed. Surgeons should acknowledge these disparities and consider disaggregating Asian races in prognosis analysis to enhance understanding of race's impact on outcomes. Recognizing these differences is crucial for guiding personalized treatment strategies, optimizing resource allocation, and informing health policy to ensure equitable cancer care for all Asian populations.
亚裔患者尽管种族和遗传背景各不相同，但常被归为一类。癌症结局是由遗传、环境和社会经济因素复杂相互作用导致的。本研究旨在描述亚洲族裔亚组中肺癌生存结局的差异，假设各亚组之间存在显著的结局差异。：对2020年国家癌症数据库进行回顾性分析，确定了IV期非小细胞肺癌（NSCLC）患者。亚洲患者被细分为九组：中国人、日本人、韩国人、亚洲印度人/巴基斯坦人、越南人、太平洋岛民、菲律宾人、老挝人/苗族人/柬埔寨人/泰国人，以及其他未另行说明的亚洲人/亚洲人（未另作说明）。主要结局是总生存期，次要结局是姑息治疗的使用情况。采用Kaplan-Meier分析以及多变量Cox和逻辑回归模型来评估感兴趣的结局。：共确定了23747例IV期NSCLC亚洲患者。各亚组的人口统计学特征在年龄、性别、Charlson-Deyo合并症指数和姑息治疗的使用方面存在差异。多变量Cox分析显示，相对于华裔亚洲人，被归类为日本人、韩国人、太平洋岛民、菲律宾人以及老挝人/苗族人/柬埔寨人/泰国人的患者生存结局较差。亚洲亚组之间姑息治疗的使用率也有所不同。与中国患者相比，被归类为日本人和太平洋岛民的患者更有可能接受姑息治疗。：在亚洲亚组中，观察到IV期NSCLC患者的生存结局和姑息治疗使用率存在差异。外科医生应认识到这些差异，并在预后分析中考虑对亚洲种族进行细分，以加深对种族对结局影响的理解。认识到这些差异对于指导个性化治疗策略、优化资源分配以及为卫生政策提供信息以确保为所有亚洲人群提供公平的癌症护理至关重要。
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