Survival of Black and White Patients With Stage IV Small Cell Lung Cancer
BackgroundSmall cell lung cancer (SCLC) is associated with aggressive biology and limited treatment options, making this disease a historical challenge. The influence of race and socioeconomic status on the survival of stage IV SCLC remains mostly unknown. Our study is designed to investigate the cl...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.773958/full |
| _version_ | 1818402378848665600 |
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| author | Huashan Shi Kexun Zhou Jordan Cochuyt David Hodge Hong Qin Rami Manochakian Yujie Zhao Sikander Ailawadhi Alex A. Adjei Yanyan Lou |
| author_facet | Huashan Shi Kexun Zhou Jordan Cochuyt David Hodge Hong Qin Rami Manochakian Yujie Zhao Sikander Ailawadhi Alex A. Adjei Yanyan Lou |
| author_sort | Huashan Shi |
| collection | DOAJ |
| description | BackgroundSmall cell lung cancer (SCLC) is associated with aggressive biology and limited treatment options, making this disease a historical challenge. The influence of race and socioeconomic status on the survival of stage IV SCLC remains mostly unknown. Our study is designed to investigate the clinical survival outcomes in Black and White patients with stage IV SCLC and study the demographic, socioeconomic, clinical features, and treatment patterns of the disease and their impact on survival in Blacks and Whites.Methods and ResultsStage IV SCLC cases from the National Cancer Database (NCDB) diagnosed between 2004 and 2014 were obtained. The follow-up endpoint is defined as death or the date of the last contact. Patients were divided into two groups by white and black. Features including demographic, socioeconomic, clinical, treatments and survival outcomes in Blacks and Whites were collected. Mortality hazard ratios of Blacks and Whites stage IV SCLC patients were analyzed. Survival of stage IV SCLC Black and White patients was also analyzed. Adjusted hazard ratios were analyzed by Cox proportional hazards regression models. Patients’ median follow-up time was 8.18 (2.37-15.84) months. Overall survival at 6, 12, 18 and 24 months were 52.4%, 25.7%, 13.2% and 7.9% in Blacks in compared to 51.0%, 23.6%, 11.5% and 6.9% in Whites. White patients had significantly higher socioeconomic status than Black patients. By contrast, Blacks were found associated with younger age at diagnosis, a significantly higher chance of receiving radiation therapy and treatments at an academic/research program. Compared to Whites, Blacks had a 9% decreased risk of death.ConclusionOur study demonstrated that Blacks have significant socioeconomic disadvantages compared to Whites. However, despite these unfavorable factors, survival for Blacks was significantly improved compared to Whites after covariable adjustment. This may be due to Blacks with Stage IV SCLC having a higher chance of receiving radiation therapy and treatments at an academic/research program. Identifying and removing the barriers to obtaining treatments at academic/research programs or improving the management in non-academic centers could improve the overall survival of stage IV SCLC. |
| first_indexed | 2024-12-14T08:07:25Z |
| format | Article |
| id | doaj.art-e82b721c7a4c41e99e514d7a49a1f78f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-14T08:07:25Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e82b721c7a4c41e99e514d7a49a1f78f2022-12-21T23:10:08ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-12-011110.3389/fonc.2021.773958773958Survival of Black and White Patients With Stage IV Small Cell Lung CancerHuashan Shi0Kexun Zhou1Jordan Cochuyt2David Hodge3Hong Qin4Rami Manochakian5Yujie Zhao6Sikander Ailawadhi7Alex A. Adjei8Yanyan Lou9Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, United StatesDepartment of Cancer Biology, Mayo Clinic, Jacksonville, FL, United StatesDepartment of Health Sciences Research/Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, United StatesDepartment of Health Sciences Research/Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, United StatesDivision of Medical Oncology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, United StatesBackgroundSmall cell lung cancer (SCLC) is associated with aggressive biology and limited treatment options, making this disease a historical challenge. The influence of race and socioeconomic status on the survival of stage IV SCLC remains mostly unknown. Our study is designed to investigate the clinical survival outcomes in Black and White patients with stage IV SCLC and study the demographic, socioeconomic, clinical features, and treatment patterns of the disease and their impact on survival in Blacks and Whites.Methods and ResultsStage IV SCLC cases from the National Cancer Database (NCDB) diagnosed between 2004 and 2014 were obtained. The follow-up endpoint is defined as death or the date of the last contact. Patients were divided into two groups by white and black. Features including demographic, socioeconomic, clinical, treatments and survival outcomes in Blacks and Whites were collected. Mortality hazard ratios of Blacks and Whites stage IV SCLC patients were analyzed. Survival of stage IV SCLC Black and White patients was also analyzed. Adjusted hazard ratios were analyzed by Cox proportional hazards regression models. Patients’ median follow-up time was 8.18 (2.37-15.84) months. Overall survival at 6, 12, 18 and 24 months were 52.4%, 25.7%, 13.2% and 7.9% in Blacks in compared to 51.0%, 23.6%, 11.5% and 6.9% in Whites. White patients had significantly higher socioeconomic status than Black patients. By contrast, Blacks were found associated with younger age at diagnosis, a significantly higher chance of receiving radiation therapy and treatments at an academic/research program. Compared to Whites, Blacks had a 9% decreased risk of death.ConclusionOur study demonstrated that Blacks have significant socioeconomic disadvantages compared to Whites. However, despite these unfavorable factors, survival for Blacks was significantly improved compared to Whites after covariable adjustment. This may be due to Blacks with Stage IV SCLC having a higher chance of receiving radiation therapy and treatments at an academic/research program. Identifying and removing the barriers to obtaining treatments at academic/research programs or improving the management in non-academic centers could improve the overall survival of stage IV SCLC.https://www.frontiersin.org/articles/10.3389/fonc.2021.773958/fullstage IV Small cell lung cancerracialsocioeconomic statussurvivalacademic program |
| spellingShingle | Huashan Shi Kexun Zhou Jordan Cochuyt David Hodge Hong Qin Rami Manochakian Yujie Zhao Sikander Ailawadhi Alex A. Adjei Yanyan Lou Survival of Black and White Patients With Stage IV Small Cell Lung Cancer Frontiers in Oncology stage IV Small cell lung cancer racial socioeconomic status survival academic program |
| title | Survival of Black and White Patients With Stage IV Small Cell Lung Cancer |
| title_full | Survival of Black and White Patients With Stage IV Small Cell Lung Cancer |
| title_fullStr | Survival of Black and White Patients With Stage IV Small Cell Lung Cancer |
| title_full_unstemmed | Survival of Black and White Patients With Stage IV Small Cell Lung Cancer |
| title_short | Survival of Black and White Patients With Stage IV Small Cell Lung Cancer |
| title_sort | survival of black and white patients with stage iv small cell lung cancer |
| topic | stage IV Small cell lung cancer racial socioeconomic status survival academic program |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.773958/full |
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