Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study
Introduction Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer. Methods The 2004–2017 National Cance...
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| Veröffentlicht in: | Langenbeck's archives of surgery 2024-04, Vol.409 (1), p.140, Article 140 |
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| creator | Aitken, Gabriela L. Motta, Monique Samuels, Shenae Gannon, Christopher J. Llaguna, Omar H. |
| description | Introduction
Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer.
Methods
The 2004–2017 National Cancer Database was queried for patients with non-metastatic colon cancer who underwent colectomy. TOO was defined as: negative margins (R0), adequate lymphadenectomy (LAD) (n ≥ 12), no prolonged length of stay (LOS), no 30-day readmission or mortality, and initiation of systemic therapy in ≤ 12 weeks. Racial groups were defined as White, Black, or Hispanic.
Results
508,312 patients were identified of which 34% achieved TOO. Blacks attained the least TOO (31.4%) as well as the TOO criteria of adequate LAD (81.1%), no prolonged LOS (52.3%), and no 30-day readmission (89.7%). Hispanics were least likely to have met the criteria of R0 resection (94.3%), no 30-day mortality (87.3%), and initiation of systemic therapy in ≤ 12 weeks (81.8%). Patients who attained TOO had a higher median overall survival (OS) than those without TOO (148.2 vs. 84.2 months;
P
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| doi_str_mv | 10.1007/s00423-024-03330-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3047943143</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3047943143</sourcerecordid><originalsourceid>FETCH-LOGICAL-c298t-df7e4cfb48303e22aae5f22ae77f738cf97121a8ce1fe2acfd61718540efe05f3</originalsourceid><addsrcrecordid>eNp9UcuO1DAQtBCIXRZ-gAPykUvAr4wz3NCKl7QSEoKz1eO0Z70k7sF2BPkM_hgvWRAnTv2qqpaqGHsqxQsphH1ZhDBKd0KZTmitRbfeY-fS6L5Tppf3_-nP2KNSboQQO7s3D9mZHnZ2Z5U8Zz8_gY8w8TGWE-RYIxYeE6_XyKFWiGnGVDkFXvFHPRB95ZQ8TXSMntNSPc2NEGia6HtMR95O6CvNa9vl24kS95A85lcceIIaKbVv24qPUOEABRvwmnLlpS7j-pg9CDAVfHJXL9iXt28-X77vrj6--3D5-qrzaj_UbgwWjQ8HM2ihUSkA7EMraG2wevBhb6WSMHiUARX4MO6klUNvBAYUfdAX7Pmme8r0bcFS3RyLx2mChLQUp4VpZunmYYOqDeozlZIxuFOOM-TVSeFuo3BbFK5F4X5H4dZGenanvxxmHP9S_njfAHoDlHZKR8zuhpbc7Cn_k_0FE-2ZKQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3047943143</pqid></control><display><type>article</type><title>Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Aitken, Gabriela L. ; Motta, Monique ; Samuels, Shenae ; Gannon, Christopher J. ; Llaguna, Omar H.</creator><creatorcontrib>Aitken, Gabriela L. ; Motta, Monique ; Samuels, Shenae ; Gannon, Christopher J. ; Llaguna, Omar H.</creatorcontrib><description>Introduction
Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer.
Methods
The 2004–2017 National Cancer Database was queried for patients with non-metastatic colon cancer who underwent colectomy. TOO was defined as: negative margins (R0), adequate lymphadenectomy (LAD) (n ≥ 12), no prolonged length of stay (LOS), no 30-day readmission or mortality, and initiation of systemic therapy in ≤ 12 weeks. Racial groups were defined as White, Black, or Hispanic.
Results
508,312 patients were identified of which 34% achieved TOO. Blacks attained the least TOO (31.4%) as well as the TOO criteria of adequate LAD (81.1%), no prolonged LOS (52.3%), and no 30-day readmission (89.7%). Hispanics were least likely to have met the criteria of R0 resection (94.3%), no 30-day mortality (87.3%), and initiation of systemic therapy in ≤ 12 weeks (81.8%). Patients who attained TOO had a higher median overall survival (OS) than those without TOO (148.2 vs. 84.2 months;
P
< 0.001). Hispanic TOO patients had the highest median OS (181.2 months), while White non-TOO patients experienced the lowest (80.2 months,
P
< 0.001). Multivariate logistic regression models suggest that Black and Hispanic patients are less likely to achieve TOO than their White counterparts.
Conclusions
Racial disparities exist in the achievement of TOO, with Blacks and Hispanics being less likely to attain TOO compared to their White counterparts.</description><identifier>ISSN: 1435-2451</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-024-03330-y</identifier><identifier>PMID: 38676721</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Cardiac Surgery ; Cohort Studies ; Colectomy ; Colonic Neoplasms - ethnology ; Colonic Neoplasms - mortality ; Colonic Neoplasms - pathology ; Colonic Neoplasms - surgery ; Databases, Factual ; Female ; General Surgery ; Healthcare Disparities - ethnology ; Healthcare Disparities - statistics & numerical data ; Hispanic or Latino - statistics & numerical data ; Humans ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Retrospective Studies ; Thoracic Surgery ; Traumatic Surgery ; Treatment Outcome ; United States ; Vascular Surgery ; White People - statistics & numerical data</subject><ispartof>Langenbeck's archives of surgery, 2024-04, Vol.409 (1), p.140, Article 140</ispartof><rights>This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024</rights><rights>2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-df7e4cfb48303e22aae5f22ae77f738cf97121a8ce1fe2acfd61718540efe05f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-024-03330-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-024-03330-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38676721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aitken, Gabriela L.</creatorcontrib><creatorcontrib>Motta, Monique</creatorcontrib><creatorcontrib>Samuels, Shenae</creatorcontrib><creatorcontrib>Gannon, Christopher J.</creatorcontrib><creatorcontrib>Llaguna, Omar H.</creatorcontrib><title>Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Introduction
Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer.
Methods
The 2004–2017 National Cancer Database was queried for patients with non-metastatic colon cancer who underwent colectomy. TOO was defined as: negative margins (R0), adequate lymphadenectomy (LAD) (n ≥ 12), no prolonged length of stay (LOS), no 30-day readmission or mortality, and initiation of systemic therapy in ≤ 12 weeks. Racial groups were defined as White, Black, or Hispanic.
Results
508,312 patients were identified of which 34% achieved TOO. Blacks attained the least TOO (31.4%) as well as the TOO criteria of adequate LAD (81.1%), no prolonged LOS (52.3%), and no 30-day readmission (89.7%). Hispanics were least likely to have met the criteria of R0 resection (94.3%), no 30-day mortality (87.3%), and initiation of systemic therapy in ≤ 12 weeks (81.8%). Patients who attained TOO had a higher median overall survival (OS) than those without TOO (148.2 vs. 84.2 months;
P
< 0.001). Hispanic TOO patients had the highest median OS (181.2 months), while White non-TOO patients experienced the lowest (80.2 months,
P
< 0.001). Multivariate logistic regression models suggest that Black and Hispanic patients are less likely to achieve TOO than their White counterparts.
Conclusions
Racial disparities exist in the achievement of TOO, with Blacks and Hispanics being less likely to attain TOO compared to their White counterparts.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Cohort Studies</subject><subject>Colectomy</subject><subject>Colonic Neoplasms - ethnology</subject><subject>Colonic Neoplasms - mortality</subject><subject>Colonic Neoplasms - pathology</subject><subject>Colonic Neoplasms - surgery</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>General Surgery</subject><subject>Healthcare Disparities - ethnology</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Hispanic or Latino - statistics & numerical data</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Thoracic Surgery</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>United States</subject><subject>Vascular Surgery</subject><subject>White People - statistics & numerical data</subject><issn>1435-2451</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcuO1DAQtBCIXRZ-gAPykUvAr4wz3NCKl7QSEoKz1eO0Z70k7sF2BPkM_hgvWRAnTv2qqpaqGHsqxQsphH1ZhDBKd0KZTmitRbfeY-fS6L5Tppf3_-nP2KNSboQQO7s3D9mZHnZ2Z5U8Zz8_gY8w8TGWE-RYIxYeE6_XyKFWiGnGVDkFXvFHPRB95ZQ8TXSMntNSPc2NEGia6HtMR95O6CvNa9vl24kS95A85lcceIIaKbVv24qPUOEABRvwmnLlpS7j-pg9CDAVfHJXL9iXt28-X77vrj6--3D5-qrzaj_UbgwWjQ8HM2ihUSkA7EMraG2wevBhb6WSMHiUARX4MO6klUNvBAYUfdAX7Pmme8r0bcFS3RyLx2mChLQUp4VpZunmYYOqDeozlZIxuFOOM-TVSeFuo3BbFK5F4X5H4dZGenanvxxmHP9S_njfAHoDlHZKR8zuhpbc7Cn_k_0FE-2ZKQ</recordid><startdate>20240427</startdate><enddate>20240427</enddate><creator>Aitken, Gabriela L.</creator><creator>Motta, Monique</creator><creator>Samuels, Shenae</creator><creator>Gannon, Christopher J.</creator><creator>Llaguna, Omar H.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240427</creationdate><title>Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study</title><author>Aitken, Gabriela L. ; Motta, Monique ; Samuels, Shenae ; Gannon, Christopher J. ; Llaguna, Omar H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c298t-df7e4cfb48303e22aae5f22ae77f738cf97121a8ce1fe2acfd61718540efe05f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Surgery</topic><topic>Cohort Studies</topic><topic>Colectomy</topic><topic>Colonic Neoplasms - ethnology</topic><topic>Colonic Neoplasms - mortality</topic><topic>Colonic Neoplasms - pathology</topic><topic>Colonic Neoplasms - surgery</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>General Surgery</topic><topic>Healthcare Disparities - ethnology</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Hispanic or Latino - statistics & numerical data</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Thoracic Surgery</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>United States</topic><topic>Vascular Surgery</topic><topic>White People - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aitken, Gabriela L.</creatorcontrib><creatorcontrib>Motta, Monique</creatorcontrib><creatorcontrib>Samuels, Shenae</creatorcontrib><creatorcontrib>Gannon, Christopher J.</creatorcontrib><creatorcontrib>Llaguna, Omar H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aitken, Gabriela L.</au><au>Motta, Monique</au><au>Samuels, Shenae</au><au>Gannon, Christopher J.</au><au>Llaguna, Omar H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2024-04-27</date><risdate>2024</risdate><volume>409</volume><issue>1</issue><spage>140</spage><pages>140-</pages><artnum>140</artnum><issn>1435-2451</issn><eissn>1435-2451</eissn><abstract>Introduction
Textbook oncologic outcome (TOO) is attained when all desired short-term quality metrics are met following an oncologic operation. The objective of this study was to determine the impact of race on TOO attainment following colectomy for colon cancer.
Methods
The 2004–2017 National Cancer Database was queried for patients with non-metastatic colon cancer who underwent colectomy. TOO was defined as: negative margins (R0), adequate lymphadenectomy (LAD) (n ≥ 12), no prolonged length of stay (LOS), no 30-day readmission or mortality, and initiation of systemic therapy in ≤ 12 weeks. Racial groups were defined as White, Black, or Hispanic.
Results
508,312 patients were identified of which 34% achieved TOO. Blacks attained the least TOO (31.4%) as well as the TOO criteria of adequate LAD (81.1%), no prolonged LOS (52.3%), and no 30-day readmission (89.7%). Hispanics were least likely to have met the criteria of R0 resection (94.3%), no 30-day mortality (87.3%), and initiation of systemic therapy in ≤ 12 weeks (81.8%). Patients who attained TOO had a higher median overall survival (OS) than those without TOO (148.2 vs. 84.2 months;
P
< 0.001). Hispanic TOO patients had the highest median OS (181.2 months), while White non-TOO patients experienced the lowest (80.2 months,
P
< 0.001). Multivariate logistic regression models suggest that Black and Hispanic patients are less likely to achieve TOO than their White counterparts.
Conclusions
Racial disparities exist in the achievement of TOO, with Blacks and Hispanics being less likely to attain TOO compared to their White counterparts.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38676721</pmid><doi>10.1007/s00423-024-03330-y</doi></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Adult Aged Cardiac Surgery Cohort Studies Colectomy Colonic Neoplasms - ethnology Colonic Neoplasms - mortality Colonic Neoplasms - pathology Colonic Neoplasms - surgery Databases, Factual Female General Surgery Healthcare Disparities - ethnology Healthcare Disparities - statistics & numerical data Hispanic or Latino - statistics & numerical data Humans Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Retrospective Studies Thoracic Surgery Traumatic Surgery Treatment Outcome United States Vascular Surgery White People - statistics & numerical data |
| title | Racial disparities in the attainment of textbook oncologic outcomes following colectomy for colon cancer: a national cancer database cohort study |
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