Racial and Socioeconomic Disparities in Cutaneous T-Cell Lymphoma Survival: Insights From the National Cancer Database.

IF 2.7 4区医学 Q2 HEMATOLOGY

Clinical Lymphoma, Myeloma & Leukemia Pub Date : 2025-05-07 DOI:10.1016/j.clml.2025.05.002

Pamela Allen, Yuan Li, Muhammad Hamid, Jessi Zhi

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引用次数: 0

Abstract

Objective: To analyze the impacts of treatment related factors, race, and social determinants of health (SDOH) on patients with cutaneous T-cell lymphoma (CTCL) using a hospital-based registry system.

Methods: Patients with CTCL diagnosed from 2004 to 2019 were identified from the National Cancer Database (NCDB). Kaplan-Meier analysis, Cox proportional hazards regression models, and Propensity Score Matching (PSM) were conducted to compare the overall survival between white and Black patients.

Results: The NCDB cohort (n = 16,189) included 12,266 (75.8%) white patients, 2849 (17.6%) Black patients, and 1074 (6.6%) other races. There were differences in disease, treatment characteristics and SDOH by racial group. Black patients traveled shorter distances (20.3% vs. 28.9%, P < .001) for treatment and were more likely to reside in urban centers. Rurality (HR 1.74 (1.41-2.15)) and treatment at non-academic/research programs (HR 1.21 (95% CI, 1.11-1.31) were associated with increased risks of death. PSM controlling for demographic, disease, SDOH, and treatment-related variables, demonstrated increased risk of death among Black patients (HR:1.20 (95% CI, 1.10-1.30) P < .001).

Limitations: Lack of detailed treatment data and misclassified cases may limit the validity of the study.

Conclusion: Black patients have a 20% increased risk of death despite controlling for patient, disease, treatment, and social factors.

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皮肤t细胞淋巴瘤生存的种族和社会经济差异：来自国家癌症数据库的见解。

目的：利用医院登记系统分析治疗相关因素、种族和健康社会决定因素（SDOH）对皮肤t细胞淋巴瘤（CTCL）患者的影响。方法：从国家癌症数据库（NCDB）中识别2004年至2019年诊断为CTCL的患者。采用Kaplan-Meier分析、Cox比例风险回归模型和倾向评分匹配（PSM）比较白人和黑人患者的总生存率。结果：NCDB队列（n = 16189）包括12266例（75.8%）白人患者，2849例（17.6%）黑人患者和1074例（6.6%）其他种族患者。在疾病、治疗特点和SDOH方面存在种族差异。黑人患者的治疗路程较短（20.3%比28.9%,P < 0.001），更有可能居住在城市中心。乡村性（HR 1.74(1.41-2.15)）和非学术/研究项目治疗(HR 1.21 （95% CI, 1.11-1.31）与死亡风险增加相关。在人口统计学、疾病、SDOH和治疗相关变量的控制下，PSM显示黑人患者的死亡风险增加（HR:1.20 (95% CI, 1.10-1.30) P < 0.001）。局限性：缺乏详细的治疗数据和错误的病例分类可能会限制研究的有效性。结论：在控制患者、疾病、治疗和社会因素的情况下，黑人患者的死亡风险增加20%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Lymphoma, Myeloma & Leukemia ONCOLOGY-HEMATOLOGY

CiteScore

2.70

自引率

3.70%

发文量

1606

审稿时长

26 days

期刊介绍： Clinical Lymphoma, Myeloma & Leukemia is a peer-reviewed monthly journal that publishes original articles describing various aspects of clinical and translational research of lymphoma, myeloma and leukemia. Clinical Lymphoma, Myeloma & Leukemia is devoted to articles on detection, diagnosis, prevention, and treatment of lymphoma, myeloma, leukemia and related disorders including macroglobulinemia, amyloidosis, and plasma-cell dyscrasias. The main emphasis is on recent scientific developments in all areas related to lymphoma, myeloma and leukemia. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.