Lee Christina I, Abubakar Sharafudeen D, Wu Fan, Thompson Hannah M, Shah Farheen, Waters Michele, Yuval Jonathan B, Williams Hannah, Luthra Anisha, Omer Dana M, Chen Chin-Tung, Garcia-Aguilar Julio, Sanchez-Vega Francisco
Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Cancer Res Commun. 2025 Jul 1;5(7):1171-1179. doi: 10.1158/2767-9764.CRC-24-0633.
In this study, we examined racial disparities in guideline-concordant care (GCC) and clinical outcomes of patients with colon cancer treated at a single comprehensive cancer center. We analyzed data from self-reported Hispanic, non-Hispanic Black (NHB), and non-Hispanic White (NHW) patients who underwent curative colectomy for stage I to III colon cancer between 2006 and 2021 at Memorial Sloan Kettering Cancer Center. GCC was defined as retrieval of ≥12 lymph nodes and appropriate receipt of adjuvant chemotherapy. Recurrence and overall survival from the time of surgery were compared using the Kaplan-Meier method and the log-rank test. Multivariable analyses were performed using Cox regression. The study included 2,209 patients, with 1,911 NHW, 153 NHB, and 145 Hispanic patients. NHW patients were older, whereas NHB patients had higher percentages of Medicaid coverage, obesity, and lower socioeconomic status. NHB patients more often presented with stage III disease and underwent open surgery. Receipt of GCC was not different by race. NHB patients had the highest 5-year recurrence rate compared with NHW and Hispanic patients (27% vs. 15.7% vs. 15.1%; P = 0.03). NHB race (HR = 1.43; P = 0.07) and low body mass index (HR = 1.98; P = 0.05) were associated with an increased risk of recurrence with marginal significance. NHB race was associated with an increased risk of recurrence in stage I disease (HR = 3.52; P = 0.03). NHB patients had shorter recurrence-free survival, despite standardized quality of care. NHB race was independently associated with an increased risk of recurrence in stage I disease.
This study compares receipt of GCC, disease recurrence, and survival among White, Black, and Hispanic patients with nonmetastatic colon cancer treated at a single comprehensive cancer center with standardized quality of care and comparable access to health care. Black patients had higher rates of recurrence in this study.
在本研究中，我们调查了在一家综合性癌症中心接受治疗的结肠癌患者在遵循指南治疗（GCC）及临床结局方面的种族差异。我们分析了2006年至2021年期间在纪念斯隆凯特琳癌症中心接受I至III期结肠癌根治性结肠切除术的自我报告为西班牙裔、非西班牙裔黑人（NHB）和非西班牙裔白人（NHW）患者的数据。GCC定义为切除≥12个淋巴结并适当接受辅助化疗。采用Kaplan-Meier法和对数秩检验比较手术时间后的复发率和总生存率。使用Cox回归进行多变量分析。该研究纳入了2209例患者，其中1911例NHW患者、153例NHB患者和145例西班牙裔患者。NHW患者年龄较大，而NHB患者的医疗补助覆盖比例、肥胖率较高，社会经济地位较低。NHB患者更常表现为III期疾病并接受开放手术。GCC的接受情况在种族间无差异。与NHW和西班牙裔患者相比，NHB患者的5年复发率最高（27%对15.7%对15.1%；P = 0.03）。NHB种族（HR = 1.43；P = 0.07）和低体重指数（HR = 1.98；P = 0.05）与复发风险增加相关，具有边缘显著性。NHB种族与I期疾病复发风险增加相关（HR = 3.52；P = 0.03）。尽管医疗质量标准化，NHB患者的无复发生存期较短。NHB种族与I期疾病复发风险增加独立相关。
本研究比较了在一家综合性癌症中心接受标准化医疗质量且获得医疗保健机会相当的非转移性结肠癌白人、黑人及西班牙裔患者的GCC接受情况、疾病复发率和生存率。本研究中黑人患者的复发率较高。
