Racial Differences in Survival after Surgical Treatment for Melanoma

Collins, Karen; Fields, Ryan C.; Baptiste, Dadrie; Liu, Ying; Moley, Jeffrey F.; Jeffe, Donna B.

doi:10.1245/s10434-011-1706-3

Cited by 54 publications

(78 citation statements)

References 42 publications

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“…Similar risk-adjusted models have since demonstrated that non-white race is an independent predictor for increased post-operative mortality following congenital heart disease operations[1]. Recent adult surgical literature has also implicated race as a predictor of post-operative morbidity, mortality, and increased length of stay[10, 21–23]. Collectively, these data support consideration of race in both risk stratification and healthcare reform aimed at the elimination of disparity within the care of children.…”

Section: Discussionmentioning

confidence: 95%

The effect of race and gender on pediatric surgical outcomes within the United States

Stone

LaPar

Kane

et al. 2013

Journal of Pediatric Surgery

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Purpose The purpose of this study was to examine risk-adjusted associations between race and gender on postoperative morbidity, mortality, and resource utilization in pediatric surgical patients within the United States. Methods 91,891 pediatric surgical patients were evaluated using the U.S. national KID Inpatient Database (2003 and 2006): appendectomy (81.2%), pyloromyotomy (9.8%), intussusception (6.2%), decortication (1.9%), congenital diaphragmatic hernia repair (0.7%), and colonic resection for Hirschsprung’s disease (0.2%). Patients were stratified according to gender (male: 62.6%, n=57,557) and race: white (n=52,334), Hispanic (n=25,697), black (n=6,951), Asian (n=1,855), Native American (n=470), and other (n=4,584). Multivariable logistic regression modeling was utilized to evaluate risk-adjusted associations between race, gender, and outcomes. Results After risk-adjustment, race was independently associated with in-hospital death (p=0.02), with an increased risk for black children. Gender was not associated with mortality (p=0.77). Post-operative morbidity was significantly associated with gender (p<0.001) and race (p=0.008). Gender (p=0.003) and race (p<0.001) were further associated with increased hospital length of stay. Importantly, these results were dependent on operation type. Conclusion Race and gender significantly affect post-operative outcomes following pediatric surgery. Black patients are at disproportionate risk for post-operative mortality, while black and Hispanic patients have increased morbidity and hospital resource utilization. While gender does not affect mortality, gender is a determinant of both post-operative morbidity and increased resource utilization.

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Section: Discussionmentioning

confidence: 95%

The effect of race and gender on pediatric surgical outcomes within the United States

Stone

LaPar

Kane

et al. 2013

Journal of Pediatric Surgery

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“…The Table illustrates our current knowledge on this topic organized along the cancer continuum. 2–4,6–13,27,29,33,37,38,40,46–55,59–62,65,68,70,71,73,74 …”

Section: Gaps In Knowledgementioning

confidence: 99%

“…4 Evidence also suggests variability in the quality of care received by minority patients with cutaneous melanoma. A Surveillance, Epidemiology, and End Results–based study found that blacks were less likely than Caucasians to receive surgical treatment for melanoma, 13 and those who underwent surgery experienced shorter survival time than other races. 13 …”

Section: Introductionmentioning

confidence: 99%

Social Determinants of Racial and Ethnic Disparities in Cutaneous Melanoma Outcomes

et al. 2014

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Background This article sought to elucidate how aspects of poverty and culture may contribute to race- and ethnicity-based disparities in cutaneous melanoma outcomes. Methods We identified published studies addressing the social determinants of melanoma. Selected review articles included US-based studies comprised of patients representing adults, children, and adolescents. Results African Americans and Hispanics diagnosed with cutaneous melanoma are more likely to present with more advanced stages of disease at diagnosis and have higher rates of mortality than their nonminority counterparts. These disparities may be a consequence of economic, social, and cultural barriers such as low income, public forms of health insurance, lower levels of education, lower levels of melanoma awareness and knowledge, and lower rates of participation in melanoma screening. No studies in the literature examined the potential impact of social injustice, English proficiency, immigrant status, and health literacy. Conclusions Substantial gaps exist in our knowledge of the pathways linking social determinants and race- and ethnicity-based disparities in melanoma. More studies are warranted to inform the development of effective interventions aimed at narrowing inequities and improving cutaneous melanoma outcomes among minority populations.

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“…This disproportion is mainly attributed to the substantially higher risk of melanoma in this racial group [2]; however, emerging evidence suggests that non-White racial groups are more likely to experience unfavorable prognoses despite their lower incidence [27]. Large-scale studies on the population of the United States generally, and of California, New York, Connecticut, and Florida specifically, identified socioeconomic and racial disparities in association with melanoma [7, 8, 12, 27-36]. Most of these studies used cancer registry records and the Surveillance, Epidemiology, and End Results (SEER) database.…”

Section: Introductionmentioning

confidence: 99%

Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission

et al. 2018

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Objective: In this study, we aimed to examine the association of demographic and socioeconomic factors with cutaneous melanoma that required admission. Methods: A cross-sectional study utilizing the Nationwide Inpatient Sample database, 2003–2009, was merged with County Health Rankings Data. Results: A total of 2,765 discharge records were included. Men were more likely to have melanoma in the head, neck, and trunk regions (p < 0.001), while extremities melanoma was more common in women (p < 0.001). Males had a higher risk of lymph node metastasis on presentation (OR 1.54, 95% CI [1.27–1.89]). Blacks and Hispanics were more likely to present with extremities melanoma. Patients with low annual income were more likely to be treated by low-volume surgeons and in hospitals located in high-risk communities (p < 0.05 each). Patients with Medicaid coverage were twice as likely to present with distant metastasis and were more likely to be managed by low-volume surgeons (p < 0.05 each). Conclusions: The presentation and outcomes of cutaneous melanoma have a distinct pattern of distribution based on patients’ characteristics.

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Racial Differences in Survival after Surgical Treatment for Melanoma

Cited by 54 publications

References 42 publications

The effect of race and gender on pediatric surgical outcomes within the United States

The effect of race and gender on pediatric surgical outcomes within the United States

Social Determinants of Racial and Ethnic Disparities in Cutaneous Melanoma Outcomes

Disparities in the Presentation and Management of Cutaneous Melanoma That Required Admission

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