Geena Jung, Ashley Stone, Shaynie Segal, Juan Lin, Bradley Schiff, Thomas Ow, Vikas Mehta, Richard V Smith
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引用次数: 0
摘要
背景:本研究阐明了头颈部鳞状细胞癌(HNSCC)预后的性别差异,并调查了其与种族的相互作用。方法:将452例确诊为HNSCC的患者按性别和种族分组。生存率分析采用Kaplan-Meier曲线、对数秩检验和多变量Cox模型,在调整混杂因素的同时评估性别/种族之间的关联。结果:男性更容易患晚期癌症(79.6%,n = 257 vs. 70.5%, n = 91; p = 0.040)。非裔美国女性的5年总体生存率最高,其次是白人女性和西班牙裔男性。非裔美国男性的存活率最差(p = 0.0334)。在控制混杂变量后(HR = 0.343; 95% CI: 0.154-0.766; p = 0.0090),非裔美国人人群中的这种性别差异仍然存在,并且在hpv阴性病例中更为明显(HR = 0.184, 95% CI = 0.043-0.786)。结论:种族分层分析显示非裔美国女性比男性有生存优势。进一步的分析表明,HPV状态和种族一起,缓和了性别对HNSCC结果的影响。证据等级:3;
Examining the Interaction Between Sex and Race in Outcomes of Head and Neck Squamous Cell Carcinoma.
Background: This study elucidated sex disparities in head and neck squamous cell carcinoma (HNSCC) outcomes and investigated their interaction with race.
Methods: A total of 452 patients diagnosed with HNSCC were grouped by sex and race. Survival was analyzed using Kaplan-Meier curves with log rank tests and multivariable Cox models to assess sex/race associations while adjusting for confounders.
Results: Males were more likely to have advanced-stage cancer (79.6%, n = 257 vs. 70.5%, n = 91; p = 0.040). African American females had the best 5-year overall survival, followed by White females and Hispanic males. African American males had the worst survival (p = 0.0334). This sex disparity within the African American population persisted when controlling for confounding variables (HR = 0.343; 95% CI: 0.154-0.766; p = 0.0090) and was more pronounced in HPV-negative cases (HR = 0.184, 95% CI = 0.043-0.786).
Conclusions: Race-stratified analysis revealed a survival advantage for African American females over males. Further analysis shows that HPV status, alongside race, moderates the effect of sex on HNSCC outcomes.
期刊介绍:
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.