Abstract:
BACKGROUND:As tumor burden increases in colorectal cancer, treatment complexity progresses from colectomy to hepatectomy and lastly to cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC). The aim of this study was to evaluate whether disparities exist in the access to progressively more complex surgical treatment options. METHODS:Patients undergoing surgery for colorectal cancer were grouped by treatment type: group 1 (n = 224) underwent colectomy for nonmetastatic disease, group 2 (n = 112) underwent hepatectomy for liver metastasis, and group 3 (n = 112) underwent CRS-HIPEC for carcinomatosis. RESULTS:Whites were predominant in the HIPEC group (71.4 %) compared to the hepatectomy (67.9 %) and colectomy (57.6 %) groups (p = 0.025). The majority of the privately insured patients were in the HIPEC group (70.5 %) compared to the hepatectomy (56.2 %) and colectomy (30.4 %) groups (p < 0.0001). Distance traveled to the hospital was farthest on average in the HIPEC group (104.6 ± 258.3 km) compared to the hepatectomy (29.0 ± 28.0 km) or colectomy (26.4 ± 66.2 km) group (p < 0.0001). Mean household income also varied between the three groups, with HIPEC patients earning $56,957 (±24,124), hepatectomy patients earning $56,999 (±28,588), and colectomy patients earning ($51,518 ± 24,201) (p = 0.0503) on average per year. The HIPEC cohort contained a higher proportion of English speakers (90.2 %) than the other groups (hepatectomy 87.9 %, colectomy 85.3 %); however, this difference was not statistically significant (p = 0.43). CONCLUSIONS:CRS-HIPEC is not accessed equally across all socioeconomic groups. Patients undergoing HIPEC were most often white, English speaking, and privately insured; had a higher mean income; and had traveled the greatest distances on average to access surgical care.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Tabrizian P,Overbey J,Carrasco-Avino G,Bagiella E,Labow DM,Sarpel Udoi
10.1245/s10434-014-4220-6subject
Has Abstractpub_date
2015-05-01 00:00:00pages
1746-50issue
5eissn
1068-9265issn
1534-4681journal_volume
22pub_type
杂志文章abstract::Breast cancer is a progressive, phenotypic, genetic and epigenetic alteration, induced by various stimulants of which the principal steroid hormone, estrogen, initiates and promotes neoplastic transformation of normal ductal mammary epithelium to acquire distinct biochemical and molecular characteristics. The molecula...
journal_title:Annals of surgical oncology
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abstract::Hilar cholangiocarcinoma is an uncommon cause of malignant biliary obstruction marked by local tumor spread for which surgery offers the only chance of cure. The diagnostic evaluation and surgical management of this disease continues to evolve. Although direct cholangiography and endoscopic biliary procedures have bee...
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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更新日期:2018-12-01 00:00:00
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更新日期:2013-01-01 00:00:00
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更新日期:2008-03-01 00:00:00
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更新日期:2015-01-01 00:00:00
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更新日期:2018-12-01 00:00:00
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更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The FAK gene encodes a 125-kDa tyrosine kinase (p125FAK) involved in signal transduction pathways used in cell adhesion, motility, and anchorage-independent growth. Because thyroid carcinomas have a wide variability in their propensity for invasion and metastasis, we studied the expression of FAK in a variet...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:1996-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved the survival in selected colorectal cancer patients with peritoneal metastases. In these patients, the risk of a low anastomosis is sometimes diminished through the creation of a colostomy. Currently, the morbidity...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2014-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2007-03-01 00:00:00