旨在评估在广泛恢复开放手术技术之前，黑人患者接受开放式根治性子宫切除术的比例是否较高，是否可以缩小生存差异，并确定其他可采取行动的因素来实现系统性改变。这是一项回顾性队列研究，包括来自国家癌症中心的患者2010 年至 2018 年接受根治性子宫切除术的宫颈癌癌症数据库。按种族和手术途径比较患者人口统计数据、临床特征和生存率。构建了卡普兰-迈耶图。使用 Cox 比例风险模型来调整协变量。7201 名患者符合纳入条件，其中 687 名（9.5%）黑人和 4870 名（68%）白人。我们发现 51% 的黑人患者和 39% 的白人患者接受了开放手术。黑人患者接受指南一致护理 (GCC) 的可能性降低 10%。与私人保险相比，购买公共资助保险的人的死亡风险高出 40% (CI 1.19-1.73 p < 0.001)。与接受 MIS 手术的白人患者相比，接受开放手术的黑人患者的 5 年生存率相似（0.90 vs 0.91，NS）。在调整了年龄、保险、淋巴结状态和淋巴血管间隙侵犯等潜在混杂因素后，接受手术的黑人患者的死亡风险比白人患者高 40%（HR 1.40 95% CI 1.10-1.79，p = 0.007）。无论采用何种手术方法，黑人患者的 5 年和 10 年生存率较低。对显着协变量的调整并未解决这种差异，证实这些因素并未充分考虑种族差异。版权所有 © 2023 Elsevier Inc. 保留所有权利。

To evaluate if the higher rate of open radical hysterectomy in Black patients, prior to the widespread return to open surgical techniques, mitigated survival disparities and to identify other actionable factors to target for systemic change.This is a retrospective cohort study including patients from the National Cancer Database with cervical cancer who underwent radical hysterectomy from 2010 to 2018. Patient demographics, clinical characteristics and survival were compared by race and surgical route. Kaplan-Meier plots were constructed. Cox proportional hazards modeling was used to adjust for covariates.7201 patients were eligible for inclusion, 687 (9.5%) Black and 4870 (68%) White. We found that 51% of Black patients and 39% of White patients underwent open surgery. Black patients were 10% less likely to receive Guideline Concordant Care (GCC). Those with publicly-funded insurance had a 40% higher hazard of death compared to private insurance (CI 1.19-1.73 p < 0.001). Black patients who had open surgery had similar 5-year survival compared to White patients who had MIS surgery (0.90 vs 0.91, NS). After adjusting for potential confounders including age, insurance, nodal status, and lymphovascular space invasion, Black patients who had surgery had a 40% higher hazard for death (HR 1.40 95% CI 1.10-1.79, p = 0.007) compared to White patients.A lower 5 and 10-year survival was seen in Black patients, regardless of surgical approach. Adjustment for significant covariates did not resolve this disparity, confirming that these factors do not fully account racial disparities.Copyright © 2023 Elsevier Inc. All rights reserved.