@article{JGO24964,
author = {Amy C. Moreno and Ning Zhang and Vivek Verma and Sharon H. Giordano and Steven H. Lin},
title = {Treatment disparities affect outcomes for patients with stage I esophageal cancer: a national cancer data base analysis},
journal = {Journal of Gastrointestinal Oncology},
volume = {10},
number = {1},
year = {2018},
keywords = {},
abstract = {Background: To examine patterns of care and outcomes for patients with stage I esophageal cancer (EC) in the United States.
Methods: We identified patients in the National Cancer Data Base diagnosed with stage I EC from 2004 to 2012 and grouped them by primary treatment: esophagectomy (Eso), local excision (LE), concurrent chemoradiation (CRT), or observation (Obs). Multinomial logistic regression was used to predict receipt of treatments. Overall survival (OS) was estimated by Kaplan-Meier methods adjusted for inverse probability of treatment weighting (IPTW) and Cox proportional hazard regressions.
Results: Of 5,480 patients, 2,312 (42%) underwent Eso, 1,250 (23%) LE, 758 (14%) CRT, and 1,160 (21%) Obs. LE use increased over time from 17% to 29% while Obs declined from 26% to 19%. Patients least likely to undergo surgery were older, had greater comorbidity, were uninsured, were treated at non-academic centers, and were Black. The rate of surgery for Black patients was half of that for White patients (33% vs. 67%). Postoperative mortality rates were higher after Eso vs. LE at 30 days (2.9% vs. 0.5%; P},
issn = {2219-679X}, url = {https://jgo.amegroups.org/article/view/24964}
}