دورية أكاديمية
أعرض في EDS

Social Vulnerability and Receipt of Neoadjuvant Chemotherapy in Patients Undergoing Radical Cystectomy for Bladder Cancer.

التفاصيل البيبلوغرافية
العنوان: Social Vulnerability and Receipt of Neoadjuvant Chemotherapy in Patients Undergoing Radical Cystectomy for Bladder Cancer.
المؤلفون: Sekar RR; Department of Urology, University of Michigan, Ann Arbor, MI; National Clinician Scholars Program, University of Michigan, Ann Arbor, MI. Electronic address: rsekar@med.umich.edu., Irani S; Department of Urology, University of Michigan, Ann Arbor, MI., Maganty A; Department of Urology, University of Michigan, Ann Arbor, MI., Montgomery JS; Department of Urology, University of Michigan, Ann Arbor, MI., Herrel LA; Department of Urology, University of Michigan, Ann Arbor, MI.
المصدر: Urology [Urology] 2024 May 18. Date of Electronic Publication: 2024 May 18.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE
أسماء مطبوعة: Publication: New York : Elsevier Science
Original Publication: Ridgewood, N.J., Professional Medical Services Co.
مستخلص: Objective: To evaluate the association between a population-level measure of social determinants of health, the Centers for Disease Control and Prevention Social Vulnerability Index (SVI), and receipt of neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy.
Methods: We queried our institutional database for patients with nonmetastatic MIBC treated with radical cystectomy between 2000 and 2022. Patients were assigned an SVI via ZIP code of residence and grouped into quintiles of SVI (ie, least vulnerable to most vulnerable). Multivariable logistic regression was performed to evaluate the association between SVI and receipt of neoadjuvant chemotherapy, adjusting for age, race, gender, and cancer stage. A sub-analysis was performed to evaluate the association between subthemes of SVI (socioeconomic status, household composition/disability, race/ethnicity/language, and housing/transportation) and receipt of neoadjuvant chemotherapy.
Results: Of the 978 patients identified, 490 (50.1%) received neoadjuvant chemotherapy. Patients that received neoadjuvant chemotherapy had a lower SVI, were younger, and had >cT2 stage (all, P <.05). The most vulnerable patients had lower odds of receiving neoadjuvant chemotherapy (OR 0.61, 0.39-0.95) compared to the least vulnerable patients. Analysis of subthemes of SVI demonstrated similar associations by socioeconomic status (OR 0.56, 0.36-0.86) and household composition/disability (OR 0.57, 0.33-0.99).
Conclusion: Adverse social determinants of health, or social vulnerability, are associated with suboptimal and disparate utilization of neoadjuvant chemotherapy in patients with MIBC undergoing radical cystectomy. Strategies for identifying vulnerable populations may allow for more targeted interventions that would improve equity in bladder cancer care.
Competing Interests: Declaration of Competing Interest Rishi R. Sekar reports a relationship with Bladder Cancer Advocacy Network that includes funding grants and reports a relationship with National Institutes of Health that includes funding grants. Lindsey A. Herrel reports a relationship with National Institute of Health that includes funding grants. The remaining authors declare that they have no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20240519 Latest Revision: 20240530
رمز التحديث: 20240531
DOI: 10.1016/j.urology.2024.05.006
PMID: 38763474
قاعدة البيانات: MEDLINE
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