Survival In Hispanic Patients Research Articles

The Prognostic Significance of Nativity, Enclave Residence, and Socioeconomic Status Among Hispanic Patients with Hepatocellular Carcinoma.

Residence in ethnic enclaves and nativity are both associated with survival in Hispanic patients with cancer, although their prognostic significance in patients with hepatocellular carcinoma (HCC) is unknown. We aimed to determine the association between nativity, neighborhood socioeconomic status (nSES), and ethnic enclave residency with overall survival in Hispanic patients with HCC. Hispanic patients diagnosed with HCC from 2004 to 2017 were identified in the Texas Cancer Registry. Existing indices were applied to tract-level 2000 US Census data to measure enclave residence and nSES. Enclaves were defined by seven measures. Multivariable Cox proportional hazard models were used to evaluate the association between nativity, enclave residency, and nSES with survival. Among 9496 Hispanic patients with HCC, 2283 (24%) were foreign-born. Compared with US-born Hispanic patients, foreign-born Hispanic patients were less likely to present with localized HCC (45.3% vs. 48.8%, p=0.03) and less likely to receive HCC treatment (53.9% vs. 47.6%, p<0.001); however, foreign-born Hispanic patients had lower mortality in adjusted models (adjusted hazard ratio [aHR] 0.86, 95% confidence interval [CI] 0.79-0.93). Neighborhood SES, but not enclave residence, was also associated with overall survival. Compared with those in low nSES non-enclaves, Hispanic patients in high nSES neighborhoods, with either enclave (aHR 0.80, 95% CI 0.72-0.88) or non-enclave (aHR 0.89, 95% CI 0.80-0.98) residence status and low nSES enclaves (aHR 0.93, 95% CI 0.86-0.98) had improved survival. In Hispanic patients with HCC, foreign birthplace and higher nSES, but not enclave residence, are associated with improved survival. Additional research on intersectionality between ethnicity, nativity, and neighborhood context is warranted.

DISP-17. OUTCOMES, CLINICAL AND MOLECULAR CHARACTERISTICS OF HISPANIC PATIENTS WITH IDH WILDTYPE GLIOBLASTOMA

Abstract BACKGROUND Knowledge about outcomes in Hispanic patients with gliomas is scant and mainly derived from tumor registries. IDH wild-type glioblastomas (GBM) are the most common and aggressive malignant primary brain tumor. Hispanics account for 19% of US population, reaching 29% in Florida and 65% in Miami-Dade County. As a reference center for GBM serving the community of South Florida we provide care for many Hispanic patients. Herein, we aim to describe the clinical and molecular features, including RNA seq analysis of Hispanic vs non-Hispanic patients with IDH wild-type GBM. METHODS Retrospective study of adult patients with diagnosis of IDH Wild-type Glioblastoma, who had NGS testing, treated at University of Miami. RESULTS 179 patients were included, 63 (35%) were Hispanic. 41 (65%) of Hispanic patients were males as compared to 65 (56%) of the non-Hispanics. Median age at diagnosis was 54 years (45-67) for the Hispanic vs 62 (54-72) years for non-Hispanic, p=.002. With a median follow up of 17 months (CI 95% 14-19), median overall survival for Hispanic patients was 22 months (18-25) and 23 months (18-28) for non-Hispanics, p=.99. 42 (23%) patients were enrolled in clinical trials, of whom 21 (50%) were Hispanic, meaning 33% of Hispanic patients enrolled. The molecular characteristics from these patients by next-generation sequencing, including RNA seq, are being analyzed. CONCLUSIONS In our series of IDH wild-type Glioblastomas, Hispanic patients were significantly younger at diagnosis compared to non-Hispanic patients, but there were no differences in overall survival. 33% of Hispanic patients were enrolled in clinical trials. As the latest growing ethnic group in the USA, major efforts have to be made to better understand the disease characteristics and outcomes of this particular population. To our knowledge this will be the first report of the molecular characteristics by NGS from Hispanic patients with GBM.

Multi-hospital retrospective study comparing gastric adenocarcinoma in Hispanic versus non-Hispanic patients.

e16027 Background: Gastric cancer is one of the most prevalent malignancies in the United States and carries a particularly high rate of mortality. In the United States, the overall gastric cancer rate continues to decline amongst Caucasian and African American patients; however, it remains static amongst Hispanic patients. While numerous studies have been conducted to better understand the underlying causes leading to the disproportionate incidence of gastric cancer among Hispanics, it is still not well understood. This retrospective study sought to compare the clinicopathological features and overall survival of Hispanic patients with gastric adenocarcinoma with non-Hispanic patients treated in three safety-net county hospitals in Southern California. Methods: This is a retrospective cohort study of 123 patients with newly diagnosed gastric adenocarcinoma who were treated at three safety-net county hospitals in Southern California between 2010 and 2022. The subjects were categorized as Hispanic and non-Hispanic. Clinical, pathological, and survival data were obtained from the patient chart and compared. Results: Of the 123 patients included in the study, 87 (71%) were Hispanic. At time of diagnosis, Hispanic patients were found to be significantly younger than non-Hispanics (55.4 +/- 13.5 vs 60.8 +/- 12.2, p-value 0.03). They were also more likely to be misdiagnosed (defined as greater than one prior encounter of misdiagnosis within six months) relative to non-Hispanics (26% vs 14%, p-value 0.007) despite no differences in insurance/PCP status. Hispanic patients were more likely to present with metastatic disease (65% vs 30%, p-value &lt;0.001), and were found to have a higher rate of peritoneal carcinomatosis (30% vs 8%, p-value 0.01). Hispanics were also more likely to present with disease in the gastric antrum (47% vs 19%, p-value 0.004) and have a higher rate of diffuse subtype histology (32% vs 22%, p-value 0.05). Similar rates of Helicobacter pylori infection were found within the tissue biopsy sample using Warthin Starry stain amongst Hispanic and non-Hispanic patients (17% vs 17%). Lastly, the mortality rate was higher in Hispanics relative to non-Hispanics at time of last contact (65% vs 35%, p-value &lt;0.001). Conclusions: Upon comparing clinicopathological features and mortality among gastric cancer patients who were treated in multiple safety net county hospitals, there were significant differences noticed in Hispanic American patients. Relative to non-Hispanics, Hispanic patients were more likely to be misdiagnosed, more likely to present with metastatic disease, and have higher rates of mortality despite no disparities in insurance and PCP status. Further investigation is warranted regarding possible risk factors including exposures to possible environmental triggers or if there is a genetic predisposition in Hispanic populations.

The Prognostic Significance of HALP Index for Colon Cancer Patients in a Hispanic-Based Population.

Survival and recurrence rates following locoregional colon cancer surgical resection are highly variable. Currently used tools to assess patient risk are still imperfect. In the present work, we evaluate, for the first time, the prognostic value of the recently developed HALP (hemoglobin, albumin, lymphocyte, and platelet) index in Hispanic colon cancer patients. Patients and Methods. We conducted a retrospective cohort study in Mexican patients with a nonmetastatic colon cancer diagnosis who underwent surgical resection. We determined the preoperative HALP score optimal cut-off value by using the X-tile software. We plotted survival curves using the Kaplan-Meier method and performed a multivariate Cox regression analysis to explore the association of preoperative HALP score with two primary endpoints: overall survival (OS) and disease-free survival (DFS). We included 640 patients (49.8% female). The optimal HALP cut-off value was 15.0. A low HALP index was statistically significantly associated with a higher TNM stage. Low HALP score was statistically significantly associated with shorter median OS in the Kaplan-Meier analysis (73.5 vs. 84.8 months) and in the multivariate Cox regression analysis (HR = 1.942, 95% CI = 1.647-2.875). There was no significant association between the HALP score and DFS. Our findings show that the HALP index is an independent factor associated with survival in Hispanic patients, despite recurrence. It seems to reflect both the anatomical extent of the disease and traditionally unaccounted nutritional and inflammatory factors that are significant for prognosis.

Outcomes in Hispanic Patients with Philadelphia-Negative and Philadelphia-like Acute Lymphoblastic Leukemia with the Use of Blinatumomab

Introduction: In the United States, Hispanics have the highest incidence rate of B-cell acute lymphoblastic leukemia (ALL) amongst all minority groups. Hispanic adults with ALL have the lowest rates of progression-free survival and overall survival. Hispanic adults, for example, have an increased frequency of Philadelphia chromosome (Ph)-like ALL, a sub-type of ALL associated with significantly inferior survival outcomes In the last decade, use of Blinatumomab and other novel targeted immunotherapies were approved for treatment of relapsed or minimal residual disease positive disease (MRD +) B-cell ALL. Pivotal trial showing efficacy of blinatumomab in relapsed or MRD + setting had very limited number of Hispanic patients. Our aim is to evaluate survival outcomes and the efficacy of blinatumomab usage in Hispanic B-ALL including Philadelphia-negative (Ph negative) and Philadelphia-like (Ph-Like) patients treated at LAC-USC (Los Angeles County Hospital-University of Southern California). We report Hispanic B-cell ALL patients treated with blinatumomab outside of clinical trials Method: This is a retrospective review which included adults aged ≥18 years with newly diagnosed Philadelphia negative ALL (2016-2020) treated at the USC/Norris Comprehensive Cancer Centerand the Los Angeles County Hospital (LAC). Primary objectives was to investigate overall survival in Hispanic patients who were treated with blinatumomab. We stratified patient population into Philadelphia negative and Philadelphia-like B-cell ALL and assessed survival separately for blinatumomab administered for minimal residual positivity and for relapse disease. Most of Ph-Like patients were identified with CRLF2 rearrangement per institutional protocol. Results: 67 patients were B cell ALL, which included Ph-negative B cell ALL and Ph-like B cell ALL, 43 and 24 patients respectively. 50.7% were men and median age was 39 years. 38 patients were considered unfavorable risk due to cytogenetics risk factors and 44 patients received peg-asparaginase based induction. 30 (48%) of patients received blinatumomab, 15 in each ph-negative and ph-like group respectively. More patients received blinatumomab for relapsed disease as compared to MRD positive disease, 23 vs. 8 patients respectively. Mean overall survival for our patients was 68 months (SE=3.3). In ph-negative group, when blinatumomab was used for relapsed disease then 3 years survival probability was 0% compared to 91.5% for patients who did not receive blinatumomab (p-value=0.0001). On the other hand, for MRD positive disease, 3 years OS was 91.7% vs. 79.6% for patients who received blinatumomab compared to no blinatumomab (p-value=0.6). For ph-like group, when blinatumomab was used for relapsed disease then 3 years survival probability was 100% compared to 40% for patients who did not receive blinatumomab (p-value=0.2). For MRD positive disease, median OS was not reached for either group (p-value=0.6). Conclusion: Both relapse disease and MRD+ disease are considered poor prognostic indicator. Our study highlights that blinatumomab can decrease survival gap for MRD + disease and relapse disease for ph-like Hispanic patients and decrease survival gap in MRD + ph-negative Hispanic patients when compared to patients who did not need blinatumomab

Survival of Hispanic patients with cutaneous melanoma: A retrospective cohort analysis of 6016 cases from the National Cancer Database

Survival of Hispanic patients with cutaneous melanoma: A retrospective cohort analysis of 6016 cases from the National Cancer Database

Waitlist mortality and transplant free survival in Hispanic patients listed for liver transplant using the UNOS database

Introduction and objectivesAfter the implementation of “Share 35”, several concerns arose such as the potential to increase travel distance, costs, and decreased liver availability. These elements could have a negative impact on waitlist outcomes among ethnic minorities. We aimed to determine waitlist survival after the implementation of the Share 35 policy in non-Hispanic white and Hispanic patients. Materials and methodsWe identified non-Hispanic whites and Hispanics who were listed for liver transplantation from June 18th, 2013 to June 18, 2018. We excluded pediatric patients, patients with acute hepatic necrosis, re-transplants, multiorgan transplant, living donor, and exception cases. The primary outcome was death or removal from the waitlist due to clinical deterioration. We used competing risk analysis to compare waitlist survival between the two groups. ResultsThere were 23,340 non-Hispanic whites and 4938 Hispanics listed for transplant. On competing risk analysis, Hispanic patients had a higher risk of being removed from the waitlist for death or clinical deterioration compared to their counterpart (SHR 1.23, 95% CI 1.13–1.34; P < 0.001). ConclusionAfter the implementation of Share 35, disparities are still present and continue to negatively impact outcomes in minority populations especially Hispanic patients.

P2.25 Immunotherapy at Any Line of Treatment Improves Survival in Hispanic Patients with Advanced Metastatic Non-Small Cell Lung Cancer (NSCLC) Compared with Chemotherapy (Quijote-CLICaP)

P2.25 Immunotherapy at Any Line of Treatment Improves Survival in Hispanic Patients with Advanced Metastatic Non-Small Cell Lung Cancer (NSCLC) Compared with Chemotherapy (Quijote-CLICaP)

P2.21 Clinical Responses and Survival in Hispanic Patients vs Non-Hispanic White Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy

P2.21 Clinical Responses and Survival in Hispanic Patients vs Non-Hispanic White Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy

EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP)

EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP)

Clinical responses and survival in Hispanic patients with non-small cell lung cancer treated with immunotherapy compared with non-Hispanic whites.

e18109 Background: The main immunotherapy (IMMUNO) trials that led to the approval of these agents for non-small cell lung cancer (NSCLC) accrued a minimum number of Hispanic (HISP) patients (pts) or, in some studies, no HISP pts at all. Additional data is thus needed to validate outcomes in HISP pts with NSCLC treated with IMMUNO. While it is known that genomic profiles and cancer survivals are different between HISP, Non-Hispanic Whites (NHW), and African-Americans; no study has yet looked at differences in IMMUNO outcomes between these populations. Methods: We present data in 436 NSCLC pts treated with IMMUNO at 5 large institutions (3 in the US, 2 in Latin America). The agents evaluated include: nivolumab, pembrolizumab and atezolizumab. 256 pts were HISP and 180 pts were NHW. Most of the pts were treated with single agent therapy as second line (or beyond) while a small group of pts were treated as first line. The primary endpoints of the study were: response rate (ORR), progression free survival (PFS) and overall survival (OS). Results: Among NHW pts, disease control rate (DCR) was 67% for Adenocarcinomas (Adeno) and 46% for squamous cell carcinomas (SQCC). In HISP pts there were no differences in DCR rates between both histologies: 68% for Adeno and 67% SQCC. There were no statistical significant differences among HISP and NHW pts regarding ORR, PFS, OS, and responses according to PD-L1 status. Conclusions: This is the largest publication and comparison of NSCLC immunotherapy outcomes in HISP vs NHW pts. No significant differences were found in the clinical outcomes between these 2 ethnic groups despite expected genomic differences. Pts with actionable mutations were excluded as they usually do not get IMMUNO as first or second line; an approach that might change after IMPOWER 150. These results are comparable to the ones seen in Checkmate and Keynote studies. As expected, higher response rates were seen in first line therapy and pts with PD-L1 (+) status. Further comparisons will be better addressed by a larger prospective study.[Table: see text]

Effect of immunotherapy at any line of treatment on survival in Hispanic patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP).

e20637 Background: To compare survival outcomes of patients with advanced or metastatic NSCLC who received immunotherapy at first, second or beyond versus matched patients receiving standard chemotherapy. Methods: A retrospective multicenter international cohort study of 296 patients with unresectable/ metastatic NSCLC treated with immunotherapy either as first, second, third or fourth line was conducted. A matched comparison with a historical cohort of first line chemotherapy was conducted. Results: Median age was 64 years (Range 34-90) and 40.2% were female patients. 91.2% of patients had an ECOG performance score ≤ 1. Immunotherapy as first line was given to 39 patients (13.7%), second line to 140 (48.8%), and as third line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67-14 months) and progression-free survival was 4.27 months (95% CI 3.97-5.0). Factors associated with increased survival included treatment as first-line (p &lt; 0.001), type of response (p &lt; 0.001) and PD-L1 status (p = 0.0039). Compared to the historical cohort, immunotherapy proved to be superior in terms of OS (p = 0.05) but not PFS (p = 0.2). Conclusions: Patients who receive immune checkpoint inhibitors as part of their treatment for NSCLC have better OS compared with matched patients treated with standard chemotherapy, regardless treatment line.

The Neutrophil-Lymphocyte Ratio Is an Independent Prognostic Factor for Overall Survival in Hispanic Patients with Gastric Adenocarcinoma.

High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are related with poor prognosis in patients with gastric cancer. However, this association has been rarely assessed in Hispanic populations that show important clinicopathological differences to Asian and Caucasian patients. In this study, we determined the prognostic value of these biomarkers in Hispanic patients from Costa Rica. We retrieved data regarding pre-treatment NLR and PLR, as well as clinical variables from medical records of 381 consecutive gastric cancer patients treated in four major hospitals in Costa Rica between 2009 and 2012. Univariate and multiple Cox regression analyses were performed to assess the value of NLR and PLR as predictors of overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test. Median follow-up was 13.21months. In univariate analysis, a NLR ≥ 5 was associated with reduced DFS (hazard ratio (HR) 2.31; 95% confidence interval (CI) 1.78-3.00; p < 0.001) and poor OS (HR 2.24; 95% CI 1.72-2.92; p < 0.001). Similarly, a PLR ≥ 350 was associated with worse DFS (HR 2.28; 95% CI 1.70-3.06; p < 0.001) and poor OS (HR 2.33; 95% CI 1.73-3.13; p < 0.001). After adjustment for potential confounders, multivariate analysis revealed that only the NLR ≥ 5 was independently associated with worse DFS (HR 1.97; 95% CI 1.44-2.47) and OS (HR 1.59; 95%CI 1.15-2.28). NLR ≥ 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer.

P-056 - Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are independent prognostic factors for overall survival in Hispanic patients with gastric adenocarcinoma

Introduction: High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are associated with poor prognosis in patients with gastric adenocarcinoma. However, the majority of these findings have been carried out in Asian countries. It is well known that outcomes of gastric cancer are different among regions, with better outcomes in patients from Asia in comparison to Western populations. Besides, recent trials have acknowledged that values of white cells can vary according to ethnicity. Therefore, in this retrospective study we aim to determine the prognostic value of NLR and PLR in Hispanic patients from Costa Rica where gastric cancer occupies the third cause of cancer-related death in both sexes. Methods: We reviewed consecutive gastric cancer patients treated in four major hospitals in Costa Rica from 2009 to 2012. Pre-treatment (before surgery or systemic treatment) NLR and PLR, as well as clinical variables were collected from medical records. Univariate and multivariate Cox regression analyses were performed to assess the relationship between NLR, PLR, overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test statistic. Results: A total of 490 patients were included in this trial. Median follow-up was 26 months. Mean age was 61.8 ±16.6 years. A total of 282 patients were male (57.6%). Surgery was performed in 309 patients (63.1%) and the most frequent procedure was partial or total gastrectomy with D2 dissection (84.1%). Clinical stage distribution was as follows: stage I: 2.8%, stage II: 27.9%, stage III: 34.8%, and stage IV: 34.5%. The optimal cutoff point for NLR and PLR was set at 5 and 350, respectively. In univariate analysis, a NLR higher than 5 was associated with reduced DFS (Hazard Ratio (HR): 2.31; 95% Confidence Interval (CI): 1.78-3.00; p < 0.001) and poor OS (HR: 2.24; 95% CI: 1.72-2.92; p < 0.001). Similarly, a PLR higher that 350 was associated with worse DFS (HR: 2.28; 95% CI: 1.70-3.06; p < 0.001) and poorer OS (HR: 2.33; 95% CI: 1.73-3.13; p < 0.001). In the multivariate analysis, after adjustment for potential confounders and interactions such as clinical stage and performance status, only the NLR higher than 5 was independently associated with worse DFS (HR: 1.84; 95% CI: 1.33-2.56) and OS (HR: 1.61; 95%CI: 1-16-2.25). Conclusion: A NLR greater than 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer. This cheap and easy to obtain biomarker can predict long-term outcomes in our population.

Racial disparities in surgical management and survival in hispanic patients with potentially resectable esophageal cancer.

4027Background: Practice patterns for potentially resectable disease are highly variable due to limited objective data to guide optimal management. Expanding on the well-known disparity in mortalit...

The impact of race/ethnicity on gallbladder cancer: An analysis of The National Cancer Data Base

Objective: Gallbladder cancer is a lethal disease with high incidence among Hispanics. However, overall survival (OS) and hazard ratios (HR) for survival among races/ethnicities have not been described. We hypothesize that stage-specific prognosis of gallbladder cancer is worse for Hispanics compared to similar non-Hispanic populations. Methods: Patients with gallbladder cancer were identified from the National Cancer Database (2007–2012), and categorized as Caucasian, Black, Hispanic, and Other. Descriptive statistics, OS, and Cox regression checking for two-way interactions were described. Results: The study identified 12,952 patients with gallbladder cancer. Median age was 71 years and 68.8% were female. The study identified 69.8% Caucasian, 13.9% Black, 11.0% Hispanic, and 5.4% Other. All-stage overall survival curves differed, with the greatest 5-year survival in Hispanic patients (27% vs. 23% Other, 18% Caucasian, and 17% Black, p < 0.001). Hispanics presented at earlier ages compared to Caucasians (67 vs 72 years, p < 0.001), were more likely to be uninsured (17.3% vs 3.9% p < 0.001), had lower income (p < 0.001), and education levels (p < 0.001) compared to Caucasians. When stratified by stage, Hispanics demonstrated greater OS for stage 0-3 disease. Following multivariate Cox regression modelling stratified for non-proportional hazards, only treatment at an academic facility (HR 0.90, 95% CI 0.84–0.97) and diagnosis year (HR 0.90, 95% CI 0.88–0.92) related to survival. Hispanic ethnicity did not show significance (p = 0.207). Conclusion: Hispanics exhibit the highest overall survival for gallbladder cancer, but after adjusting for covariates this does not appear to independently impact survival. Interestingly, treatment at an academic facility provides a survival benefit.

A Modern Radiotherapy Series of Survival in Hispanic Patients with Glioblastoma

Studies have shown racial differences in cancer outcomes. We investigate whether survival differences existed in Hispanic patients with glioblastoma (GBM) compared with other ethnicities from our modern radiotherapy series, because no study to date has focused on outcomes in this group after radiation therapy. We retrospectively evaluated 428 patients diagnosed with GBM from 1996 to 2014 at our institution, divided into 4 groups based on self-report: white, black, Hispanic, and Asian/Indian. The primary outcome was overall survival. We analyzed differences in prognostic factors among the whole cohort compared with the Hispanic cohort alone. Baseline characteristics of the 4 racial groups were comparable. With a median follow-up of 387 days, no survival differences were seen by Kaplan-Meier analysis. Median overall survival for Hispanic patients was 355 days versus 450 days for the entire cohort. Factors significant for patient outcomes in the entire cohort differed slightly from those specific to Hispanic patients. Low Karnofsky Performance Status was significant on multivariate analysis in the whole population, but not in Hispanic patients. Extent of resection, recursive partitioning analysis class, and radiation therapy total dose were significant on multivariate analysis in both the whole population and Hispanic patients. We found that Hispanic patients with GBM had no difference in survival compared with other ethnicities in our cohort. Differences exist in factors associated with outcomes on single and multivariate analysis for Hispanic patients with GBM compared with the entire cohort. Additional studies focusing on Hispanic patients will aid in more personalized treatment approaches in this group.

Lean Body Mass and Survival in Hemodialysis Patients and the Roles of Race and Ethnicity

Lean body mass (LBM) represents the "fat-free" muscle mass in hemodialysis (HD) patients and is an important nutritional measure. Previous studies have found that both higher LBM and body mass index (BMI) were related to greater survival in HD patients. Additional studies have shown differences in survival across racial-ethnic groups of HD patients. However, the association of LBM and mortality across racial-ethnic subgroups has not been examined. We hypothesize that racial differences in LBM affect the mortality in HD patients. Chronic HD patients from a large dialysis organization in the United States. Estimated LBM (eLBM), self-identified racial subgroups. 5-year survival. We examined the association between baseline eLBM and survival using Cox proportional hazard models adjusted for demographics, comorbidities, and laboratory measures. Associations were examined across subgroups of race-ethnicity (non-Hispanic white, African American, and Hispanic) and BMI. The final cohort included 117,683 HD patients, who were 62±15 (mean±standard deviation) years old, 43% women and 59% with diabetes mellitus. Higher eLBM was linearly associated with lower mortality. Compared with the reference group (48.4-<50.5kg), patients with the lowest eLBM (<41.3kg) had a 1.4-fold higher risk of mortality (hazard ratio: 1.37; 95% confidence interval: 1.30-1.44) in the fully adjusted model. A similar linear association was seen among patients with BMI < 35kg/m(2) and in non-Hispanic whites and African American subgroups. However, higher eLBM was not associated with improved survival in Hispanic patients or patients with BMI ≥ 35kg/m(2). Potential residual confounding. Higher eLBM is associated with a lower mortality risk in HD patients, especially among non-Hispanic white and African American groups. Hispanic patients do not demonstrate a similar inverse relationship. The association between LBM and mortality among different racial groups of HD patients deserves additional study.

Hispanic patients with head and neck cancer do not have a worse prognosis than Anglo-American patients

This study was undertaken to determine whether the survival of Hispanic patients with squamous cell carcinoma of the head and neck was different from that of Anglo-American patients. The charts of 275 male patients with a diagnosis of squamous cell carcinoma of the head and neck at one Veterans Administration Hospital were reviewed in an attempt to identify prognostic indicators for both ethnic groups. No differences were observed between Anglo-American and Hispanic patients with respect to sites of the primary tumor, age at diagnosis, performance status, or the frequency of surgery, radiation therapy, or chemotherapy; however, there was a tendency for Hispanic patients to have received more treatment. There also was a trend (P = 0.12) for Hispanic patients to have a more advanced stage of cancer. Hispanic patients lost significantly more weight (P less than 0.001) and had significantly lower serum albumin levels (P less than 0.0001). According to the results of multivariate survival analyses, the variables that were predictive of a poor prognosis included advanced stage of disease, decreased serum albumin levels, increased weight loss, administration of chemotherapy, lack of radiation therapy or surgery, and advanced age. Ethnicity was not a significant predictor of survival either in univariate analyses, or within patients with the same stage of disease, or after adjustment for other prognostic factors. In conclusion, the natural history of squamous cell carcinoma of the head and neck is the same for Hispanic and Anglo-American patients.