Sex differences and racial/ethnic disparities in the presentation and treatment of medullary thyroid cancer.

Autor: Kalva S; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA., Ginzberg SP; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA; Penn Center for Cancer Care Innovation, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA. Electronic address: sara.ginzberg@pennmedicine.upenn.edu., Passman JE; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA., Soegaard Ballester JM; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA., Finn CB; Department of Surgery, Weill Cornell Medicine, 525 E. 68th Street, New York, NY, 10065, USA., Fraker DL; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA., Kelz RR; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA 19104, USA., Wachtel H; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein Building, Philadelphia, PA, 19104, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Aug; Vol. 234, pp. 19-25. Date of Electronic Publication: 2024 Feb 08.
DOI: 10.1016/j.amjsurg.2024.02.009
Abstrakt: Background: This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC).
Methods: Patients with MTC (2010-2020) were identified from the National Cancer Database. Differences in disease presentation and likelihood of guideline-concordant surgical management (total thyroidectomy and resection of ≥1 lymph node) were assessed by sex and race/ethnicity.
Results: Of 6154 patients, 68.2% underwent guideline-concordant surgery. Tumors >4 ​cm were more likely in men (vs. women: OR 2.47, p ​< ​0.001) and Hispanic patients (vs. White patients: OR 1.52, p ​= ​0.001). Non-White patients were more likely to have distant metastases (Black: OR 1.63, p ​= ​0.002; Hispanic: OR 1.44, p ​= ​0.038) and experienced longer time to surgery (Black: HR 0.66, p ​< ​0.001; Hispanic: HR 0.71, p ​< ​0.001). Black patients were less likely to undergo guideline-concordant surgery (OR 0.70, p ​= ​0.022).
Conclusions: Male and non-White patients with MTC more frequently present with advanced disease, and Black patients are less likely to undergo guideline-concordant surgery.
Competing Interests: Declaration of competing interest Saiesh Kalva, Sara P. Ginzberg, Jesse E. Passman, Jacqueline M. Soegaard Ballester, Caitlin B. Finn, Douglas L. Fraker, Rachel R. Kelz, and Heather Wachtel have no conflicts of interest to disclose.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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