大肠腺癌的短期手术结果：全民可及卫生系统中的种族-民族比较

IF 2.4 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2025-09-15 DOI:10.1016/j.suronc.2025.102295

Yvonne L. Eaglehouse , Sarah Darmon , Michele M. Gage , Craig D. Shriver , Kangmin Zhu

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引用次数: 0

摘要

背景：在美国，获得治疗的机会被认为是导致结肠癌治疗接受和生存的种族差异的一个因素。对于结肠癌手术的各个方面和结果的种族差异以及是否获得治疗的机会起作用，我们知之甚少。我们旨在研究军事卫生系统（MHS）中的结肠癌手术和短期术后结果，该系统提供不考虑患者特征的护理。方法：我们使用MilCanEpi数据库识别2001年至2014年间诊断为I-III期结肠腺癌并接受结肠切除术治疗的18岁及以上患者。结果包括手术切缘阳性，淋巴结切除术不充分(结果：该研究包括157名亚洲或太平洋岛民，258名非西班牙裔黑人，111名西班牙裔和1131名非西班牙裔白人患者。总体而言，与非西班牙裔白人相比，少数族裔群体测量结果的风险没有显著差异（arr及其95% ci包括1.00）。从并发症类型来看，西班牙裔患者发生肠梗阻的风险明显低于非西班牙裔白人患者（ARR = 0.55, 95% CI = 0.32, 0.96），其他种族间差异无统计学意义。结论：在普遍可及的MHS中，在非转移性结肠癌结肠切除术30天结局的手术方面或经验方面，总体上没有显著的种族差异。

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Short-term surgical outcomes for colon adenocarcinoma: Racial-Ethnic comparisons in a universal access health system

Background

Access to care has been identified as a contributor to racial-ethnic differences in treatment receipt and survival of colon cancer in the U.S. Less is known about racial-ethnic differences in aspects and outcomes of colon cancer surgery and whether access to care plays a role. We aimed to study colon cancer surgery and short-term postoperative outcomes in the Military Health System (MHS), which provides access to care regardless of patient characteristics.

Methods

We used the MilCanEpi database to identify patients aged 18 or older who were diagnosed with stage I-III colon adenocarcinoma between 2001 and 2014 and received colectomy as treatment. Outcomes included positive surgical margins, inadequate lymphadenectomy (<12 nodes examined), 30-day complications (any; general or gastrointestinal), and 30-day hospital readmissions. Multivariable Poisson regression models estimated the adjusted risk ratios (ARRs) and 95 % confidence intervals (CIs) in association with race-ethnicity for each outcome.

Results

The study included 157 Asian or Pacific Islander, 258 non-Hispanic Black, 111 Hispanic, and 1131 non-Hispanic White patients. Overall, the risk of measured outcomes did not differ significantly for racial-ethnic minority groups compared to non-Hispanic White (ARRs and their 95 % CIs included 1.00). By complication type, Hispanic patients had significantly lower risk of bowel obstruction (ARR = 0.55, 95 % CI = 0.32, 0.96) compared to non-Hispanic White patients, with no other statistically significant racial-ethnic differences.

Conclusions

In the universal access MHS, there were no overall significant racial-ethnic differences in surgical aspects or experience of 30-day outcomes of colectomy for non-metastatic colon cancer.

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.