Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Baseline Characteristics, Demographics, and Tumor Characteristics
2.2. Survival Analysis
2.2.1. Overall Survival Analysis (Entire Cohort)
2.2.2. Cause-Specific Survival Analysis (Entire Cohort)
2.2.3. Overall Survival and Cause-Specific Survival for Patients Stratified by Primary Site
3. Discussion
4. Materials and Methods
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Overall Population (%) | Hispanic (%) | Non-Hispanic White (%) | Non-Hispanic Black (%) | p-Value ‡ | ||
---|---|---|---|---|---|---|---|
(Hispanic vs NHW) * | (Hispanic vs. NHB) * | (NHW vs. NHB) * | |||||
26,399 (100) | 3960 (15.0) | 17,183 (65.1) | 5256 (19.9) | ||||
Age (median) | 57 | 54 | 59 | 56 | |||
Year of Diagnosis | <0.001 | <0.001 | <0.001 | ||||
2004–2006 | 4394 (16.6) | 549 (13.9) | 3057 (17.8) | 788 (15.0) | |||
2007–2009 | 5272 (20.0) | 719 (18.2) | 3470 (20.2) | 1083 (20.6) | |||
2010–2012 | 6107 (23.1) | 898 (22.7) | 3932 (22.9) | 1277 (24.3) | |||
2013–2016 | 10,626 (40.3) | 1794 (45.3) | 6724 (39.1) | 2108 (40.1) | |||
Sex | <0.001 | <0.001 | <0.001 | ||||
Male | 12,670 (48) | 1840 (46.5) | 8600 (50.0) | 2230 (42.4) | |||
Female | 13,729 (52) | 2120 (53.5) | 8583 (50.0) | 3026 (57.6) | |||
Marital Status | <0.001 | <0.001 | <0.001 | ||||
Married | 14,144 (53.6) | 2093 (52.9) | 10,035 (58.4) | 2016 (38.4) | |||
Single | 4721 (17.9) | 797 (20.1) | 2488 (14.5) | 1436 (27.3) | |||
Insurance Status | <0.001 | NS | <0.001 | ||||
Yes | 19,522 (73.9) | 2919 (73.7) | 12,772 (74.3) | 3831 (72.9) | |||
No | 649 (2.5) | 150 (3.8) | 289 (1.7) | 210 (4.0) | |||
Primary Site | <0.001 | <0.001 | <0.001 | ||||
Esophagus | 376 (1.4) | 38 (1.0) | 303 (1.8) | 35 (0.7) | |||
Stomach | 3110 (11.8) | 732 (18.5) | 1918 (11.2) | 460 (8.8) | |||
Small Intestine | 9142 (34.6) | 870 (22.0) | 6674 (38.8) | 1598 (30.4) | |||
Colon | 3386 (12.8) | 432 (10.9) | 2307 (13.4) | 647 (12.3) | |||
Rectum | 8230 (31.2) | 1583 (39.9) | 4297 (25.0) | 2350 (44.7) | |||
Appendix | 2155 (8.2) | 305 (7.7) | 1684 (9.8) | 166 (3.2) | |||
Tumor Size | <0.001 | NS | <0.001 | ||||
<2 cm | 12,121 (45.9) | 1848 (46.7) | 7858 (45.7) | 2415 (45.9) | |||
2–4 cm | 4116 (15.6) | 440 (11.1) | 3025 (17.6) | 651 (12.4) | |||
>4 | 2015 (7.6) | 249 (6.3) | 1464 (8.5) | 302 (5.7) | |||
Metastasis | <0.001 | NS | <0.001 | ||||
Yes | 4062 (15.4) | 441 (11.1) | 3040 (17.7) | 581 (11.1) | |||
Stage | <0.001 | <0.001 | <0.001 | ||||
I | 6193 (23.5) | 1148 (29.0) | 3702 (21.5) | 1343 (25.6) | |||
II | 1657 (6.3) | 211 (5.3) | 1136 (6.6) | 310 (5.9) | |||
III | 3267 (12.4) | 306 (7.7) | 2457 (14.3) | 504 (9.6) | |||
IV | 3485 (13.2) | 394 (9.9) | 2601 (15.1) | 490 (9.3) | |||
Grade | <0.001 | <0.001 | <0.001 | ||||
I | 10,358 (39.2) | 1647 (41.6) | 6738 (39.2) | 1973 (37.5) | |||
II | 2181 (8.3) | 291 (7.3) | 1557 (9.1) | 333 (6.3) | |||
III | 1418 (5.4) | 183 (4.6) | 1056 (6.1) | 179 (3.4) | |||
IV | 622 (2.4) | 82 (2.1) | 469 (2.7) | 71 (1.4) | |||
Surgery | <0.001 | NS | <0.001 | ||||
Yes | 20,570 (77.9) | 2990 (75.5) | 13,579 (79.0) | 4001 (76.1) | |||
Radiotherapy | <0.001 | NS | <0.001 | ||||
Yes | 637 (2.4) | 68 (1.7) | 486 (2.8) | 83 (1.6) | |||
Chemotherapy | <0.001 | NS | <0.001 | ||||
Yes | 2099 (8.0) | 257 (6.5) | 1525 (8.9) | 317 (6.0) | |||
Overall survival | <0.001 | 0.014 | <0.001 | ||||
5-year survival rate (%) | 78 | 83 | 75 | 81 | |||
10-year survival rate (%) | 67 | 74 | 64 | 70 | |||
Cause-specific survival | <0.001 | NS | <0.001 | ||||
5-year survival rate (%) | 85 | 88 | 83 | 90 | |||
10-year survival rate (%) | 81 | 85 | 78 | 86 |
Characteristics | OS Multivariable Analysis | CSS Multivariable Analysis | ||
---|---|---|---|---|
HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Race/Ethnicity | ||||
Non-Hispanic White | Ref | Ref | ||
Non-Hispanic Black | 1.03 (0.96–1.11) | NS | 0.89 (0.80–0.98) | 0.01 |
Hispanics | 0.89 (0.81–0.97) | 0.008 | 0.90 (0.80–1.00) | NS |
Age | ||||
18–39 | Ref | Ref | ||
40–59 | 1.70 (1.43–2.01) | <0.001 | 1.54 (1.25–1.90) | <0.001 |
60–79 | 3.53 (2.97–4.19) | <0.001 | 2.58 (2.10–3.17) | <0.001 |
80+ | 9.22 (7.70–11.03) | <0.001 | 5.77 (4.62–7.19) | <0.001 |
Sex | ||||
Female | Ref | Ref | ||
Male | 1.23 (1.16–1.30) | <0.001 | 1.17 (1.09–1.26) | <0.001 |
Marital Status | ||||
Married | Ref | Ref | ||
Single | 1.41 (1.30–1.52) | <0.001 | 1.24 (1.12–1.36) | <0.001 |
Other/Unknown | 1.20 (1.13–1.28) | <0.001 | 1.10 (1.02–1.19) | 0.01 |
Insurance | ||||
Insured | Ref | Ref | ||
Uninsured | 1.75 (1.48–2.06) | <0.001 | 1.87 (1.54–2.28) | <0.001 |
Unknown | 1.13 (1.06–1.20) | 0.001 | 1.20 (1.11–1.31) | <0.001 |
Primary Site | ||||
Appendix | Ref | Ref | ||
Esophagus | 1.34 (1.07–1.68) | 0.01 | 1.37 (1.03–1.81) | 0.03 |
Stomach | 1.19 (0.98–1.45) | NS | 1.07 (0.82–1.39) | NS |
Small Intestine | 1.22 (1.009–1.47) | 0.04 | 1.21 (0.94–1.55) | NS |
Colon | 1.62 (1.34–1.96) | <0.001 | 1.80 (1.40–2.32) | <0.001 |
Rectum | 0.64 (0.53–0.78) | <0.001 | 0.65 (0.50–0.85) | 0.001 |
Grade | ||||
I | Ref | Ref | ||
II | 1.24 (1.10–1.40) | 0.001 | 1.59 (1.35–1.85) | <0.001 |
III | 3.76 (3.38–4.18) | <0.001 | 5.14 (4.50–5.87) | <0.001 |
IV | 4.01 (3.52–4.55) | <0.001 | 5.37 (4.61–6.25) | <0.001 |
Unknown | 1.48 (1.37–1.60) | <0.001 | 1.88 (1.68–2.11) | <0.001 |
Stage | ||||
I | Ref | Ref | ||
II | 1.21 (1.04–1.41) | 0.01 | 1.56 (1.21–2.00) | 0.001 |
III | 1.39 (1.21–1.59) | <0.001 | 2.47 (2.00–3.07) | <0.001 |
IV | 3.74 (3.31–4.22) | <0.001 | 7.78 (6.36–9.52) | <0.001 |
Unknown | 1.19 (1.06–1.33) | 0.004 | 1.43 (1.17–1.75) | 0.001 |
Tumor Size | ||||
<2 cm | Ref | Ref | ||
2–4 cm | 1.29 (1.19–1.40) | <0.001 | 2.05 (1.82–2.32) | <0.001 |
>4 cm | 1.56 (1.42–1.71) | <0.001 | 2.51 (2.21–2.85) | <0.001 |
Unknown | 1.09 (1.01–1.18) | 0.02 | 1.61 (1.43–1.82) | <0.001 |
Surgery | ||||
Yes | Ref | Ref | ||
No/Unknown | 2.05 (1.91–2.19) | <0.001 | 2.28 (2.09–2.49) | <0.001 |
Radiotherapy | ||||
Yes | Ref | Ref | ||
No/Unknown | 0.89 (0.79–0.99) | 0.04 | 0.87 (0.77–0.98) | 0.02 |
Chemotherapy | ||||
Yes | Ref | Ref | ||
No/Unknown | 0.75 (0.69–0.81) | <0.001 | 0.74 (0.68–0.82) | <0.001 |
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Goksu, S.Y.; Ozer, M.; Beg, M.S.; Sanford, N.N.; Ahn, C.; Fangman, B.D.; Goksu, B.B.; Verma, U.; Sanjeevaiah, A.; Hsiehchen, D.; et al. Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors. Cancers 2020, 12, 2990. https://doi.org/10.3390/cancers12102990
Goksu SY, Ozer M, Beg MS, Sanford NN, Ahn C, Fangman BD, Goksu BB, Verma U, Sanjeevaiah A, Hsiehchen D, et al. Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors. Cancers. 2020; 12(10):2990. https://doi.org/10.3390/cancers12102990
Chicago/Turabian StyleGoksu, Suleyman Yasin, Muhammet Ozer, Muhammad S. Beg, Nina Niu Sanford, Chul Ahn, Benjamin D. Fangman, Busra B. Goksu, Udit Verma, Aravind Sanjeevaiah, David Hsiehchen, and et al. 2020. "Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors" Cancers 12, no. 10: 2990. https://doi.org/10.3390/cancers12102990