TY - JOUR
T1 - Clinical outcomes of black vs. non-black patients with locally advanced non–small cell lung cancer
AU - Vyfhuis, Melissa AL
AU - Bhooshan, Neha
AU - Molitoris, Jason
AU - Bentzen, Søren M.
AU - Feliciano, Josephine
AU - Edelman, Martin
AU - Burrows, Whitney M.
AU - Nichols, Elizabeth M.
AU - Suntharalingam, Mohan
AU - Donahue, James
AU - Nagib, Marc
AU - Carr, Shamus R.
AU - Friedberg, Joseph
AU - Badiyan, Shahed
AU - Simone, Charles B.
AU - Feigenberg, Steven J.
AU - Mohindra, Pranshu
N1 - Publisher Copyright:
© 2017
PY - 2017/12
Y1 - 2017/12
N2 - Objectives The black population remains underrepresented in clinical trials despite reports suggesting greater incidence and deaths from locally advanced non-small cell lung cancer (NSCLC). We determined outcomes for black and non-black patients in a well-annotated cohort treated with either definitive chemoradiation (CRT; bimodality) or CRT followed by surgery (trimodality therapy). Materials and Methods A retrospective analysis of 355 stage III NSCLC patients treated with curative intent at the University of Maryland, Medical Center, between January 2000-December 2013 was performed. The Kaplan–Meier approach and the Cox proportional hazards models were used to analyze overall survival (OS) and freedom-from-recurrence (FFR) in black and non-black patients. The chi-square test was used to compare categorical variables. Results Black patients comprised 42% of the cohort and were more likely to be younger (p < 0.0001), male (p = 0.030), single (p < 0.0001), reside in lower household income zipcodes (p < 0.0001), have an Eastern Cooperative Oncology Group (ECOG) performance status >0 (p < 0.001), and less likely to undergo surgery (p < 0.0001). With a median follow-up of 15 months for all patients and 89 months for surviving patients (range:1–186 months), median OS times for black and non-black patients were 22 and 24 months, respectively (p = 0.698). FFR rates were also comparable between the two groups (p = 0.468). Surgery improved OS in both cohorts. Race was not a significant predictor for OS or FFR even when adjusted for other factors. Conclusions We found similar oncologic outcomes in black and non-black NSCLC patients when treated with curative intent in a comprehensive cancer center setting, despite epidemiologic differences in presentation and receipt of care. Future efforts to improve outcomes in black patients could focus on addressing modifiable social disparities.
AB - Objectives The black population remains underrepresented in clinical trials despite reports suggesting greater incidence and deaths from locally advanced non-small cell lung cancer (NSCLC). We determined outcomes for black and non-black patients in a well-annotated cohort treated with either definitive chemoradiation (CRT; bimodality) or CRT followed by surgery (trimodality therapy). Materials and Methods A retrospective analysis of 355 stage III NSCLC patients treated with curative intent at the University of Maryland, Medical Center, between January 2000-December 2013 was performed. The Kaplan–Meier approach and the Cox proportional hazards models were used to analyze overall survival (OS) and freedom-from-recurrence (FFR) in black and non-black patients. The chi-square test was used to compare categorical variables. Results Black patients comprised 42% of the cohort and were more likely to be younger (p < 0.0001), male (p = 0.030), single (p < 0.0001), reside in lower household income zipcodes (p < 0.0001), have an Eastern Cooperative Oncology Group (ECOG) performance status >0 (p < 0.001), and less likely to undergo surgery (p < 0.0001). With a median follow-up of 15 months for all patients and 89 months for surviving patients (range:1–186 months), median OS times for black and non-black patients were 22 and 24 months, respectively (p = 0.698). FFR rates were also comparable between the two groups (p = 0.468). Surgery improved OS in both cohorts. Race was not a significant predictor for OS or FFR even when adjusted for other factors. Conclusions We found similar oncologic outcomes in black and non-black NSCLC patients when treated with curative intent in a comprehensive cancer center setting, despite epidemiologic differences in presentation and receipt of care. Future efforts to improve outcomes in black patients could focus on addressing modifiable social disparities.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Black or African American/ethnology
KW - Carcinoma, Non-Small-Cell Lung/epidemiology
KW - Chemoradiotherapy/methods
KW - Disease-Free Survival
KW - Female
KW - Health Status Disparities
KW - Humans
KW - Incidence
KW - Lung Neoplasms/epidemiology
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Patient Outcome Assessment
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85032684505&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000418782300007&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.lungcan.2017.10.016
DO - 10.1016/j.lungcan.2017.10.016
M3 - Article
C2 - 29173764
SN - 0169-5002
VL - 114
SP - 44
EP - 49
JO - Lung Cancer
JF - Lung Cancer
ER -