Influence of race and geographic setting on the management of gastric adenocarcinoma
| Autor: | Santhosh Ambika, Mark B. Ulanja, Darryll R. Patterson, Steven C. Zell, Nageshwara Gullapalli, Bryce D Beutler, Mohit Rishi, Kenneth G. Konam |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male End results medicine.medical_specialty Adenocarcinoma White People Young Adult 03 medical and health sciences Race (biology) Gastric adenocarcinoma 0302 clinical medicine Stomach Neoplasms Epidemiology Ethnicity medicine Humans Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Retrospective cohort study General Medicine Odds ratio Middle Aged United States Confidence interval Logistic Models Socioeconomic Factors Oncology 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery business SEER Program Demography |
| Zdroj: | Journal of Surgical Oncology. 120:270-279 |
| ISSN: | 0022-4790 2007-2015 |
| DOI: | 10.1002/jso.25503 |
| Popis: | Background and objectives Conflicting evidence indicates that both race and geographic setting may influence the management of malignancies such as gastric adenocarcinoma (GAC). Methods We designed a retrospective cohort study utilizing data from the Surveillance, Epidemiology, and End Results program to identify patients with resectable GAC (N = 15 991). Exposures of interest were race and geographic region of diagnosis (West [WE], Midwest [MW], South [SO], or Northeast [NE]). Endpoints included: (1) recommendation against surgery and (2) gastric adenocarcinoma-specific survival (GACSS). Multivariable logistic and Cox regression models were used to identify pertinent associations. Results A total of 15 991 patients were included (2007-2015). In adjusted analysis, African American individuals more frequently received a recommendation against surgical resection than White (adjusted odds ratio [aOR] = 0.86; 95% confidence interval [CI], 0.76-0.98), Asian American (aOR = 0.55; 95% CI, 0.46-0.65), and American Indian (aOR = 0.50; 95% CI, 0.31-0.82) individuals. In addition to race-based discrepancies, there was a significant association between geography and management: individuals diagnosed with GAC in the SO were more likely to receive a recommendation against surgery (odds ratio = 1.35; 95% CI, 1.23-1.49) and exhibited poorer GACSS as compared with those in the WE, MW, or NE regions. Conclusions Race and geographic region of diagnosis affect treatment recommendations and GACSS among individuals with resectable tumors. African Americans with resectable cancers are more likely to receive a recommendation against surgery than individuals of other racial groups. |
| Databáze: | OpenAIRE |
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