Influence of race and sociodemographic factors on declining resection for gastric cancer: A national study - 08/12/20
, Susanna W.L. de Geus a, Teviah E. Sachs a, Ryan B. Morgan c, Sing Chau Ng a, David McAneny a, Jennifer F. Tseng a, ⁎ Abstract |
Background |
The purpose of this study was to determine whether racial or other demographic characteristics were associated with declining surgery for early stage gastric cancer.
Methods |
Patients with clinical stage I-II gastric adenocarcinoma were identified from the NCDB. Multivariable logistic models identified predictors for declining resection. Patients were stratified based on propensity scores, which were modeled on the probability of declining. Overall survival was evaluated using the Kaplan-Meier method.
Results |
Of 11,326 patients, 3.68% (n = 417) declined resection. Patients were more likely to refuse if they were black (p < 0.001), had Medicaid or no insurance (p < 0.001), had shorter travel distance to the hospital (p < 0.001) or were treated at a non-academic center (p = 0.001). After stratification, patients who declined surgery had worse overall survival (all strata, p < 0.001).
Conclusions |
Racial and sociodemographic disparities exist in the treatment of potentially curable gastric cancer, with patients who decline recommended surgery suffering worse overall survival.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Of 11,326 stage I-II gastric cancer patients from the NCDB, 3.68% declined surgery. |
• | Black patients and those with Medicaid or no insurance were more likely to decline. |
• | Patients who declined a gastrectomy had 4.6 times worse five-year overall survival. |
Keywords : Gastric cancer, Refusal, Disparity, Socioeconomic, Survival
Plan
Vol 221 - N° 1
P. 155-161 - janvier 2021 Retour au numéro
Article précédent
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