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Abstract：
Racial and ethnic disparities in cancer outcomes have been demonstrated for several different malignancies. In this study we aimed to quantify disease-specific survival (DSS) and the 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for paranasal sinus cancer by race and ethnicity.
Patients with sinus cancer between 1973 and 2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by race and ethnicity. Cox regression models of DSS were generated controlling for stage, age, race, and ethnicity. CDSS was calculated using Cox models. Logistic regression was conducted to identify risk factors for younger age at diagnosis, late-stage at diagnosis, and likelihood of receiving surgical intervention when recommended.
The analysis included a total of 5202 patients. DSS was significantly different when stratified by race (p < 0.01). Compared with White patients, Black patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.13-1.45; p < 0.001) and American Indian/Alaskan Natives (HR, 1.94; 95% CI, 1.37-2.74, p < 0.001) exhibited increased mortality when controlling for other factors. Black patients had worse CDSS for regional and distant staged cancer compared with other races; American Indian/Alaskan Native patients had worse CDSS for cancers of all stages. Hispanic patients were more likely to present with advanced disease (odds ratio [OR], 1.47; 95% CI, 1.07-2.07; p = 0.020). American Indian/Alaskan Native patients were less likely than White patients to receive surgical intervention when recommended (OR, 0.42; 95% CI, 0.21-0.04; p = 0.024). Nonwhite patients were more likely to be diagnosed at a younger age. Variations in racial and ethnic disparities were observed over time.
Race and ethnicity significantly impact paranasal sinus cancer outcome metrics. Disparities in outcomes are likely multifactorial.
Patients with sinus cancer between 1973 and 2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by race and ethnicity. Cox regression models of DSS were generated controlling for stage, age, race, and ethnicity. CDSS was calculated using Cox models. Logistic regression was conducted to identify risk factors for younger age at diagnosis, late-stage at diagnosis, and likelihood of receiving surgical intervention when recommended.
The analysis included a total of 5202 patients. DSS was significantly different when stratified by race (p < 0.01). Compared with White patients, Black patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.13-1.45; p < 0.001) and American Indian/Alaskan Natives (HR, 1.94; 95% CI, 1.37-2.74, p < 0.001) exhibited increased mortality when controlling for other factors. Black patients had worse CDSS for regional and distant staged cancer compared with other races; American Indian/Alaskan Native patients had worse CDSS for cancers of all stages. Hispanic patients were more likely to present with advanced disease (odds ratio [OR], 1.47; 95% CI, 1.07-2.07; p = 0.020). American Indian/Alaskan Native patients were less likely than White patients to receive surgical intervention when recommended (OR, 0.42; 95% CI, 0.21-0.04; p = 0.024). Nonwhite patients were more likely to be diagnosed at a younger age. Variations in racial and ethnic disparities were observed over time.
Race and ethnicity significantly impact paranasal sinus cancer outcome metrics. Disparities in outcomes are likely multifactorial.
摘要：
已经证明了几种不同恶性肿瘤在癌症结果中的种族和种族差异。在这项研究中，我们旨在量化疾病特异性生存率（DSS）和5年条件性疾病特异性生存率（CDSS，随着生存率的增加，预期寿命的变化）按种族和种族划分的鼻旁窦癌。
从监测中提取了1973年至2015年之间的窦癌患者，流行病学,结束结果(SEER)注册表。DSS的Kaplan-Meier分析按种族和民族分层。生成DSS的Cox回归模型，控制阶段，年龄,种族,和种族。使用Cox模型计算CDSS。进行Logistic回归以确定诊断时年龄较小的危险因素，晚期诊断，以及在推荐时接受手术干预的可能性。
分析共包括5202名患者。按种族分层时，DSS差异显着（p<0.01）。与白人患者相比，黑人患者(危险比[HR]，1.29；95%置信区间[CI]，1.13-1.45；p<0.001)和美洲印第安人/阿拉斯加土著人(HR，1.94；95%CI，1.37-2.74，p<0.001）在控制其他因素时显示死亡率增加。与其他种族相比，黑人患者在区域和远处分期癌症中的CDSS较差；美洲印第安人/阿拉斯加原住民患者在所有阶段的癌症中的CDSS较差。西班牙裔患者更有可能出现晚期疾病(比值比[OR]，1.47；95%CI，1.07-2.07；p=0.020）。美洲印第安人/阿拉斯加原住民患者在推荐时接受手术干预的可能性低于白人患者(OR，0.42；95%CI，0.21-0.04；p=0.024)。非白人患者更有可能在年轻时被诊断出来。随着时间的推移，观察到种族和族裔差异的变化。
种族和民族显著影响鼻旁窦癌预后指标。结果的差异可能是多方面的。
从监测中提取了1973年至2015年之间的窦癌患者，流行病学,结束结果(SEER)注册表。DSS的Kaplan-Meier分析按种族和民族分层。生成DSS的Cox回归模型，控制阶段，年龄,种族,和种族。使用Cox模型计算CDSS。进行Logistic回归以确定诊断时年龄较小的危险因素，晚期诊断，以及在推荐时接受手术干预的可能性。
分析共包括5202名患者。按种族分层时，DSS差异显着（p<0.01）。与白人患者相比，黑人患者(危险比[HR]，1.29；95%置信区间[CI]，1.13-1.45；p<0.001)和美洲印第安人/阿拉斯加土著人(HR，1.94；95%CI，1.37-2.74，p<0.001）在控制其他因素时显示死亡率增加。与其他种族相比，黑人患者在区域和远处分期癌症中的CDSS较差；美洲印第安人/阿拉斯加原住民患者在所有阶段的癌症中的CDSS较差。西班牙裔患者更有可能出现晚期疾病(比值比[OR]，1.47；95%CI，1.07-2.07；p=0.020）。美洲印第安人/阿拉斯加原住民患者在推荐时接受手术干预的可能性低于白人患者(OR，0.42；95%CI，0.21-0.04；p=0.024)。非白人患者更有可能在年轻时被诊断出来。随着时间的推移，观察到种族和族裔差异的变化。
种族和民族显著影响鼻旁窦癌预后指标。结果的差异可能是多方面的。
