Quyen D Chu1, Mei-Chin Hsieh2, John F Gibbs3, Xiao-Cheng Wu2. 1. Department of Surgery, LSU Health Sciences Center-Shreveport, Shreveport, LA, USA. 2. Department of Louisiana Tumor Registry & Epidemiology and School of Public Health at LSU Health Sciences-New Orleans, New Orleans, LA, USA. 3. Department of Surgery, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
Abstract
BACKGROUND: Racial disparities have long been a subject of concern between patients afflicted with pancreatic cancer in the United States. We believe that, in addition to a high-volume center, treatment at an academic research program (ARP) will mitigate racial outcome disparities. METHODS: A total of 12,950 patients diagnosed with stage I-III pancreatic adenocarcinoma from 2003-2011 and at ACS Commission on Cancer (COC) accredited facilities [e.g., high-volume (≥12 cases/year) ARPs] were evaluated from the National Cancer Data Base (NCDB). Sociodemographic, clinicopathological, and treatment variables were compared between Black (N=1,127) and White (N=11,823) patients. The Kaplan-Meier Estimator and Cox Proportional Hazards Model were used for survival analysis. P value ≤0.05 was considered significant. RESULTS: Black patients had a significantly higher overall survival (OS) than White patients, despite having a significantly lower household income, lower education level, more stage III disease, more Medicaid recipients, and higher comorbidity index (P<0.05). The 5-year unadjusted OS (28.6% versus 23.9%, a median survival time (months) was (25.2 versus 23.7 months for Black and White patients, respectively (P<0.05). There was no significant difference in surgical margin status or receipt of chemoradiation between the two cohorts. After adjusting for covariates, race was no longer a significant predictor of OS (P=0.096). CONCLUSIONS: Treatment at a high volume, ARP can mitigate racial disparities in pancreatic cancer. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
BACKGROUND: Racial disparities have long been a subject of concern between patients afflicted with pancreatic cancer in the United States. We believe that, in addition to a high-volume center, treatment at an academic research program (ARP) will mitigate racial outcome disparities. METHODS: A total of 12,950 patients diagnosed with stage I-III pancreatic adenocarcinoma from 2003-2011 and at ACS Commission on Cancer (COC) accredited facilities [e.g., high-volume (≥12 cases/year) ARPs] were evaluated from the National Cancer Data Base (NCDB). Sociodemographic, clinicopathological, and treatment variables were compared between Black (N=1,127) and White (N=11,823) patients. The Kaplan-Meier Estimator and Cox Proportional Hazards Model were used for survival analysis. P value ≤0.05 was considered significant. RESULTS: Black patients had a significantly higher overall survival (OS) than White patients, despite having a significantly lower household income, lower education level, more stage III disease, more Medicaid recipients, and higher comorbidity index (P<0.05). The 5-year unadjusted OS (28.6% versus 23.9%, a median survival time (months) was (25.2 versus 23.7 months for Black and White patients, respectively (P<0.05). There was no significant difference in surgical margin status or receipt of chemoradiation between the two cohorts. After adjusting for covariates, race was no longer a significant predictor of OS (P=0.096). CONCLUSIONS: Treatment at a high volume, ARP can mitigate racial disparities in pancreatic cancer. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
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