Supplementary Material for: Variations in Characteristics and Clinical Outcomes of Esophageal Squamous Cell Carcinoma Among Asian American

Introduction: Research on esophageal squamous cell carcinoma (ESCC) in Asian American (AsA) populations frequently aggregates data, thereby overlooking the considerable diversity inherent within this demographic. The aim of this study was to investigate the variations in ESCC characteristics and clinical outcomes among AsA. Methods: Patients diagnosed with ESCC were identified through the Surveillance, Epidemiology, and End Results (SEER) 17 database. The AsA cohort was categorized into specific subgroups: Chinese, Japanese, Filipino, Korean, Vietnamese, South Asian (Asian Indian or Pakistani), and other Asian. The Kaplan-Meier method was employed to estimate unadjusted overall survival (OS), while Cox proportional hazards models were utilized to assess adjusted OS. Results: A total of 9,252 patients were included, with the cohort comprising 1,100 Asian, 2,135 Black, 951 Hispanic, and 5,066 White individuals. AsA patients demonstrated the highest unadjusted OS (P < .001). The Vietnamese subgroup exhibited the highest proportion of male patients at 92.1%. South Asian patients showed the highest unadjusted OS among the distinct Asian subgroups, with survival rates of 56% at one year (95% CI 49–64), 31% at three years (95% CI 25–40), and 23% at five years (95% CI 17–32). After adjusting, only Chinese and South Asian patients displayed significantly improved OS compared to the White reference group (P < .05). Conclusion: Considerable disparities in ESCC characteristics and outcomes exist among AsA populations. Socioeconomic, genetic, and epigenetic factors may influence these differences. Further research is essential to clarify the mechanisms of this discrepancy.

引言：既往针对亚裔美国人（Asian American, AsA）人群的食管鳞状细胞癌（esophageal squamous cell carcinoma, ESCC）研究多采用数据聚合分析策略，因而忽略了该人群内部固有的显著异质性。本研究旨在探究亚裔美国人群体中ESCC的临床特征与预后结局差异。
方法：本研究从监测、流行病学与最终结果（Surveillance, Epidemiology, and End Results, SEER）17数据库中筛选确诊为ESCC的患者。将亚裔美国人队列细分为以下亚组：华人、日本人、菲律宾人、韩国人、越南人、南亚裔（印度裔或巴基斯坦裔）及其他亚裔人群。采用卡普兰-迈耶法（Kaplan-Meier method）估算未经校正的总生存期（overall survival, OS），并通过Cox比例风险模型（Cox proportional hazards models）评估校正后的总生存期。
结果：本研究共纳入9252例患者，队列包含1100名亚裔、2135名黑人、951名西班牙裔及5066名白人。亚裔美国人患者的未经校正总生存期最优（P < 0.001）。越南亚组的男性患者占比最高，达92.1%。在各亚裔亚组中，南亚裔患者的未经校正总生存期表现最佳，其1年生存率为56%（95%置信区间，confidence interval, CI：49~64）、3年生存率为31%（95% CI：25~40）、5年生存率为23%（95% CI：17~32）。校正混杂因素后，仅华人和南亚裔患者的总生存期较白人参照组显著更优（P < 0.05）。
结论：亚裔美国人群体中ESCC的临床特征与预后结局存在显著异质性。社会经济、遗传及表观遗传因素或可介导此类差异，未来需开展进一步研究以阐明该差异的潜在机制。