Treatment at a high-volume academic research program mitigates racial disparities in pancreatic adenocarcinoma

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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.

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Chu, Q. D., Hsieh, M. C., Gibbs, J. F., & Wu, X. C. (2021). Treatment at a high-volume academic research program mitigates racial disparities in pancreatic adenocarcinoma. Journal of Gastrointestinal Oncology, 13(6), 2579–2590. https://doi.org/10.21037/jgo-20-584

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