Veeravich Jaruvongvanich1,2, Buravej Assavapongpaiboon2, Linda Wong3. 1. Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA. 2. Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 3. Department of Surgery, University of Hawaii, Honolulu, HI, USA.
Abstract
BACKGROUND: Gallbladder cancer is a rare malignancy, yet it has a dismal prognosis. Overall survival has improved in all races/ethnicities except Hispanics and blacks. Despite improvements in gallbladder cancer management, it is not clear whether racial/ethnic disparities in stage at diagnosis and treatments exist that could potentially be the source of survival disparities. The purpose of this study was to examine race/ethnicity-specific trends in the stage of disease and receipt of treatments among adult gallbladder cancer patients in the US. METHODS: Using the 2000-2013 Surveillance, Epidemiology, and End Results (SEER) 18 registries in the US. Race/ethnicity-specific cancer stage at diagnosis and treatments received among adults with gallbladder cancer were evaluated. Differences in gallbladder cancer stage at presentation, treatment modalities and number of lymph nodes (LN) removed among each race/ethnicity were evaluated using multivariate logistic regression models. RESULTS: A total of 7,507 patients with gallbladder cancer were included. There were no racial/ethnic disparities in stage at diagnosis. With regard to disparities in treatments, blacks were significantly less likely to receive curative surgery compared to whites [adjusted odds ratio (AOR) 0.67, 95% CI: 0.56-0.80; P<0.001]. No racial/ethnic disparities in radiation therapy were observed. In patients undergoing curative surgery, Hispanics were significantly less likely to have optimal LN clearance compared to whites (AOR 0.59, 95% CI: 0.47-0.74; P<0.001). After stratification into 2-time periods (2000 to 2006 and 2007 to 2013), racial/ethnic disparities in treatments seemed to be more pronounced over time. CONCLUSIONS: Among US adults with gallbladder cancer, no racial/ethnic disparities in stage at diagnosis were observed. However, blacks, and Hispanics were less likely to receive curative surgery, and optimal LN clearance than Whites, which are consistent with the lack of survival improvements in those groups and they should be target groups for future studies to address treatment disparities.
BACKGROUND: Gallbladder cancer is a rare malignancy, yet it has a dismal prognosis. Overall survival has improved in all races/ethnicities except Hispanics and blacks. Despite improvements in gallbladder cancer management, it is not clear whether racial/ethnic disparities in stage at diagnosis and treatments exist that could potentially be the source of survival disparities. The purpose of this study was to examine race/ethnicity-specific trends in the stage of disease and receipt of treatments among adult gallbladder cancer patients in the US. METHODS: Using the 2000-2013 Surveillance, Epidemiology, and End Results (SEER) 18 registries in the US. Race/ethnicity-specific cancer stage at diagnosis and treatments received among adults with gallbladder cancer were evaluated. Differences in gallbladder cancer stage at presentation, treatment modalities and number of lymph nodes (LN) removed among each race/ethnicity were evaluated using multivariate logistic regression models. RESULTS: A total of 7,507 patients with gallbladder cancer were included. There were no racial/ethnic disparities in stage at diagnosis. With regard to disparities in treatments, blacks were significantly less likely to receive curative surgery compared to whites [adjusted odds ratio (AOR) 0.67, 95% CI: 0.56-0.80; P<0.001]. No racial/ethnic disparities in radiation therapy were observed. In patients undergoing curative surgery, Hispanics were significantly less likely to have optimal LN clearance compared to whites (AOR 0.59, 95% CI: 0.47-0.74; P<0.001). After stratification into 2-time periods (2000 to 2006 and 2007 to 2013), racial/ethnic disparities in treatments seemed to be more pronounced over time. CONCLUSIONS: Among US adults with gallbladder cancer, no racial/ethnic disparities in stage at diagnosis were observed. However, blacks, and Hispanics were less likely to receive curative surgery, and optimal LN clearance than Whites, which are consistent with the lack of survival improvements in those groups and they should be target groups for future studies to address treatment disparities.
Authors: Yinzhi Lai; Chun Wang; Jesse M Civan; Juan P Palazzo; Zhong Ye; Terry Hyslop; Jianqing Lin; Ronald E Myers; Bingshan Li; Binghua Jiang; Ashwin Sama; Jinliang Xing; Hushan Yang Journal: Gastroenterology Date: 2016-02-02 Impact factor: 22.682
Authors: Rachel M Lee; Yuan Liu; Adriana C Gamboa; Mohammad Y Zaidi; David A Kooby; Mihir M Shah; Kenneth Cardona; Maria C Russell; Shishir K Maithel Journal: J Surg Oncol Date: 2019-07-13 Impact factor: 3.454
Authors: Caroline J Rieser; Richard S Hoehn; Mazen Zenati; Lauren B Hall; Eliza Kang; Amer H Zureikat; Andrew Lee; Melanie Ongchin; Matthew P Holtzman; James F Pingpank; David L Bartlett; M Haroon A Choudry Journal: Ann Surg Oncol Date: 2021-03-09 Impact factor: 5.344
Authors: Lauren F Huang; Augustine Hong; Gino Cioffi; Asrar Alahmadi; Tin-Yun Tang; Lee M Ocuin; Nirav Patil; David L Bajor; Joel N Saltzman; Amr Mohamed; Eva Selfridge; Monica Webb Hooper; Jill Barnholtz-Sloan; Richard T Lee Journal: Front Oncol Date: 2022-02-22 Impact factor: 5.738