Importance: It has been established that disparities in race and socioeconomic status are associated with outcomes of non-small cell lung cancer. However, it remains unknown whether this extends to stage I, II, or III small cell lung cancer (SCLC), or limited-stage SCLC (L-SCLC). Objective: To investigate the associations of race, socioeconomic factors, and treatment characteristics with survival among patients with L-SCLC. Design, Setting, and Participants: Demographic information for patients with L-SCLC diagnosed between 2004 and 2014 was obtained from the National Cancer Database. The follow-up end point is death or last follow-up (date of last contact). Patients were divided into 5 mutually exclusive cohorts by race. Data analysis was performed in October 2019. Main Outcomes and Measures: Cox proportional hazards models were used to calculate univariable and multivariable models. Multivariable analyses were conducted to assess the associations of race and socioeconomic factors with risk-adjusted outcomes. Overall survival between groups was depicted by Kaplan-Meier curves. Results: Of 72 409 patients analyzed (median [range] age, 67.0 [23.0-90.0] years), 40 289 (55.6%) were women. The distribution of disease stage was 10 619 patients (14.7%) with stage I disease, 7689 patients (10.6%) with stage II disease, and 54 101 patients (74.7%) with stage III disease. The median (range) duration of follow-up was 8.2 (2.4-15.8) months. Compared with White patients, the hazard of death decreased to 0.92 (95% CI, 0.89-0.95; P < .001) for African American patients and 0.83 (95% CI, 0.77-0.91; P < .001) for Asian patients. The difference in median survival among different racial groups was significant only among those with stage III SCLC. Other factors associated with better survival were female sex, high income, high education, private insurance, diagnostic confirmation by positive cytological analysis, increase in number of sampled regional lymph nodes, and earlier stage at diagnosis. Conclusions and Relevance: This analysis highlights disparities in race and socioeconomic factors associated with outcomes of L-SCLC. Racial minorities, including African American and Asian patients, have better survival than White patients for L-SCLC after adjustment for sociodemographic factors.
Importance: It has been established that disparities in race and socioeconomic status are associated with outcomes of non-small cell lung cancer. However, it remains unknown whether this extends to stage I, II, or III small cell lung cancer (SCLC), or limited-stage SCLC (L-SCLC). Objective: To investigate the associations of race, socioeconomic factors, and treatment characteristics with survival among patients with L-SCLC. Design, Setting, and Participants: Demographic information for patients with L-SCLC diagnosed between 2004 and 2014 was obtained from the National Cancer Database. The follow-up end point is death or last follow-up (date of last contact). Patients were divided into 5 mutually exclusive cohorts by race. Data analysis was performed in October 2019. Main Outcomes and Measures: Cox proportional hazards models were used to calculate univariable and multivariable models. Multivariable analyses were conducted to assess the associations of race and socioeconomic factors with risk-adjusted outcomes. Overall survival between groups was depicted by Kaplan-Meier curves. Results: Of 72 409 patients analyzed (median [range] age, 67.0 [23.0-90.0] years), 40 289 (55.6%) were women. The distribution of disease stage was 10 619 patients (14.7%) with stage I disease, 7689 patients (10.6%) with stage II disease, and 54 101 patients (74.7%) with stage III disease. The median (range) duration of follow-up was 8.2 (2.4-15.8) months. Compared with White patients, the hazard of death decreased to 0.92 (95% CI, 0.89-0.95; P < .001) for African American patients and 0.83 (95% CI, 0.77-0.91; P < .001) for Asian patients. The difference in median survival among different racial groups was significant only among those with stage III SCLC. Other factors associated with better survival were female sex, high income, high education, private insurance, diagnostic confirmation by positive cytological analysis, increase in number of sampled regional lymph nodes, and earlier stage at diagnosis. Conclusions and Relevance: This analysis highlights disparities in race and socioeconomic factors associated with outcomes of L-SCLC. Racial minorities, including African American and Asian patients, have better survival than White patients for L-SCLC after adjustment for sociodemographic factors.
Authors: Daniel J Boffa; Joshua E Rosen; Katherine Mallin; Ashley Loomis; Greer Gay; Bryan Palis; Kathleen Thoburn; Donna Gress; Daniel P McKellar; Lawrence N Shulman; Matthew A Facktor; David P Winchester Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777
Authors: Gregory M M Videtic; Chandana A Reddy; Samuel T Chao; Thomas W Rice; David J Adelstein; Gene H Barnett; Tarek M Mekhail; Michael A Vogelbaum; John H Suh Journal: Int J Radiat Oncol Biol Phys Date: 2009-03-26 Impact factor: 7.038
Authors: Pamela M Marcus; Vincent Paul Doria-Rose; Ilana F Gareen; Brenda Brewer; Kathy Clingan; Kristen Keating; Jennifer Rosenbaum; Heather M Rozjabek; Joshua Rathmell; JoRean Sicks; Anthony B Miller Journal: Clin Trials Date: 2016-03-22 Impact factor: 2.486
Authors: Yanyan Lou; Bhagirathbhai Dholaria; Aixa Soyano; David Hodge; Jordan Cochuyt; Rami Manochakian; Stephen J Ko; Mathew Thomas; Margaret M Johnson; Neal M Patel; Robert C Miller; Alex A Adjei; Sikander Ailawadhi Journal: Cancer Med Date: 2018-09-02 Impact factor: 4.452
Authors: Muhammad Rafiqul Islam; A T M Kamrul Hasan; Nazrina Khatun; Ishrat Nur Ridi; Md Mamun Or Rasheed; Syed Mohammad Ariful Islam; Md Nazmul Karim Journal: PLoS One Date: 2021-12-10 Impact factor: 3.240
Authors: Huashan Shi; Kexun Zhou; Jordan Cochuyt; David Hodge; Hong Qin; Rami Manochakian; Yujie Zhao; Sikander Ailawadhi; Alex A Adjei; Yanyan Lou Journal: Front Oncol Date: 2021-12-10 Impact factor: 6.244