Journal of surgical oncology · 2025
Multimodal Care and Outcomes of Pancreatic Cancer Patients Are Influenced by Factors Beyond Biology: A Population-Based Study From Louisiana Tumor Registry.
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Galatas Aimée, Malinosky Hannah R, Chapple Andrew G, McManus Sydney, Byerley Ann, Littlefield Ethan, Hemelt Sarah, Lyons John, Danos Denise, Moaven Omeed
Аннотация
BACKGROUND: This study aims to evaluate potential disparities in multimodal treatment and its impact on outcomes among pancreatic cancer patients in Louisiana.
METHODS: Data on pancreatic cancer cases diagnosed between 2000 and 2020 were obtained from the Louisiana Tumor Registry. Bivariate relationships were assessed via Chi-square tests. Treatment was modeled with logistic regression models. Time-to-treatment was modeled with negative binomial regression models. Overall survival was analyzed with Cox proportional hazards models. Results are reported as odds ratio (OR), rate ratios (RR), hazards ratio (HR), and 95% Wald confidence intervals.
RESULTS: A total of 8,466 patients with pancreatic cancer were included. A significantly higher proportion of nonmetastatic cases received therapy compared to metastatic cases. Non-Hispanic Black patients with nonmetastatic disease experienced a significantly longer time to treatment compared to Non-Hispanic White patients. In the metastatic model, uninsured patients and those with Medicaid had the highest odds of not receiving therapy. Primary resection was a strong predictor of improved survival. Nonsurgical therapy also contributed to better outcomes.
CONCLUSION: The findings of this study are instrumental in designing a more granular investigation of multi-level determinants to identify the actionable items driving the observed disparities associated with worse outcomes.
METHODS: Data on pancreatic cancer cases diagnosed between 2000 and 2020 were obtained from the Louisiana Tumor Registry. Bivariate relationships were assessed via Chi-square tests. Treatment was modeled with logistic regression models. Time-to-treatment was modeled with negative binomial regression models. Overall survival was analyzed with Cox proportional hazards models. Results are reported as odds ratio (OR), rate ratios (RR), hazards ratio (HR), and 95% Wald confidence intervals.
RESULTS: A total of 8,466 patients with pancreatic cancer were included. A significantly higher proportion of nonmetastatic cases received therapy compared to metastatic cases. Non-Hispanic Black patients with nonmetastatic disease experienced a significantly longer time to treatment compared to Non-Hispanic White patients. In the metastatic model, uninsured patients and those with Medicaid had the highest odds of not receiving therapy. Primary resection was a strong predictor of improved survival. Nonsurgical therapy also contributed to better outcomes.
CONCLUSION: The findings of this study are instrumental in designing a more granular investigation of multi-level determinants to identify the actionable items driving the observed disparities associated with worse outcomes.