由于“患者危险因素”，新诊断的晚期子宫内膜癌患者不推荐化疗的差异

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2026-04-01 Epub Date: 2026-03-28 DOI:10.1016/j.gore.2026.102072

Xuan Li , Allison Dona , Sarah Boyle , Katherine Cooke , Deanna Teoh , Rachel I. Vogel

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引用次数: 0

摘要

目的：我们试图确定诊断为晚期子宫内膜癌的患者因“患者危险因素”而不推荐化疗的患者社会人口学特征。方法：我们利用国家癌症数据库（NCDB）对2004-2021年间新诊断为III期或IV期子宫内膜癌的个体进行了回顾性分析。主要结果显示，与推荐的化疗相比，“由于患者危险因素（即合并症、高龄[…]），不推荐/不推荐化疗”，无论给药方式如何。logistic回归模型检验了患者社会人口学特征（年龄、种族、民族、教育程度、保险类型、城市/农村居住）与因患者危险因素而不推荐化疗之间的关系，调整了临床因素，包括Charlson-Deyo合并症指数评分、分期、组织学、分级和设施类型。结果在纳入分析的96497名患者中，由于“患者风险因素”，有2030人（2.1%）不推荐化疗。年龄增长、黑人种族、居住在高中毕业率较低的邮政编码地区、没有保险或政府保险，在调整临床变量后，不推荐化疗是独立相关的。敏感度分析排除了更可能有临床禁忌症的亚组，包括那些没有手术，有Charlson-Deyo合并症指数评分为0，或在手术后30天内死亡的亚组，发现了类似的结果。结论：尽管国家综合癌症网络指南推荐化疗作为晚期子宫内膜癌的一线治疗，但根据种族、年龄、教育程度和保险状况等社会人口因素，化疗推荐存在差异。

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Disparities in not recommending chemotherapy for individuals with newly diagnosed advanced endometrial cancer due to “patient risk factors”

Objectives

We sought to identify patient sociodemographic characteristics associated with not recommending chemotherapy due to “patient risk factors” for individuals diagnosed with advanced-stage endometrial cancer. Methods: We conducted a retrospective analysis of individuals newly diagnosed with stage III or IV endometrial cancer between 2004–2021 utilizing the National Cancer Database (NCDB). The primary outcome was indication that “chemotherapy was not recommended/administered because it was contraindicated due to patient risk factors (i.e., comorbid conditions, advanced age […])” compared to chemotherapy recommended, regardless of administration. A logistic regression model examined associations between patient sociodemographic characteristics (age, race, ethnicity, education, type of insurance, urban/rural residence) and not recommending chemotherapy due to patient risk factors, adjusting for clinical factors including Charlson-Deyo comorbidity index scores, stage, histology, grade, and facility type.

Results

Among the 96,497 individuals included in the analysis, chemotherapy was not recommended for 2,030 (2.1%) due to “patient risk factors.” Increasing age, Black race, living in a zip code with lower rates of high school completion, and having no insurance or government insurance were independently associated with chemotherapy not being recommended after adjusting for clinical variables. Sensitivity analyses excluding subgroups more likely to have clinical contraindications, including those who did not have surgery, had a Charlson-Deyo comorbidity index score > 0, or died within 30 days of surgery found similar results.

Conclusions

Despite National Comprehensive Cancer Network guidelines recommending chemotherapy for frontline treatment of advanced-stage endometrial cancer, disparities in recommendations for chemotherapy were observed by sociodemographic factors including race, age, education, and insurance status.

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.