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Lung Cancer |

Non-small Cell Lung Cancer: Clinical Differences Among Hispanics and Non-Hispanic Whites at the John Theurer Cancer Center (JTCC), Hackensack University Medical Center

Narjust Perez-Florez; Larysa Gromko; Dina Khateeb; Harry D. Harper; Bernard Park; Martin Gutierrez
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Rutgers-New Jersey Medical School, Newark, NJ


Chest. 2014;146(4_MeetingAbstracts):606A. doi:10.1378/chest.1994380
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Abstract

SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: It has been observed that the incidence and mortality of lung cancer among Hispanics (H) are significantly lower than in non-Hispanic whites (NHW). This epidemiological phenomenon has been described as the “Hispanic paradox.” The aim of this study was to compare clinicopathological characteristics and survival between NHW and H with non-small cell lung cancer (NSCLC).

METHODS: Records of 592 patients diagnosed with NSCLC between 2005 and 2012 at the JTCC were studied. Initial tissue diagnosis and adequate follow up were required. Demographics, histology, recurrence, and survival rate among NHW and H were analyzed. Chi-square test was used to estimate differences in categorical data; Kaplan-Meier and Wilcoxon methods were used for the survival analysis.

RESULTS: There were 370 NHW and 222 H. Mean age at diagnosis was 68 years for NHW and 67 years for H. At diagnosis, 172 (47%) of NHW were stage IV compared with 80 (36%) of H (p<0.02). On the other hand 96 (26%) of NHW were stage I vs. 82 (37%) of H (p>0.004). NHW were more likely to have upper lobe and poorly differentiated tumors when compared to H (56% vs. 45%, p<0.01; 65% vs. 54%, p<0.01, respectively). Squamous cell carcinoma was the most prevalent histologic type in NHW (49%) vs. adenocarcinoma in H (47%). H had a higher recurrence rate than NHW (14% vs. 7%, p<0.009). Median survival was 24 months in NHW (95% CI: 17.4-30.1) and 38 months in H (95% CI: 28.2-48.3), p<0.03. Race (OR: 1.47, p<0.02) and history of surgery (OR: 0.46, p<0.001) were independent and significant predictors of survival by multivariate analysis. Remission was not achieved in 244 (66%) of NHW vs. 126 (57%) of H (p<0.02).

CONCLUSIONS: The findings of this study confirm the “Hispanic paradox” when comparing survival in NHW vs. H with NSCLC. NHW were more likely to have poorly differentiated tumors, to present with advanced disease at diagnosis and had shorter overall survival when compared to H.

CLINICAL IMPLICATIONS: Further research is needed to identify factors that may account for the disparity in lung cancer incidence and mortality between NHW and H.

DISCLOSURE: The following authors have nothing to disclose: Narjust Perez-Florez, Larysa Gromko, Dina Khateeb, Harry D. Harper, Bernard Park, Martin Gutierrez

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