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Adjuvant therapy rates and overall survival in patients with localized pancreatic cancer from high Area Deprivation Index neighborhoods. Am J Surg 2021 07;222(1):10-17

Date

12/15/2020

Pubmed ID

33308823

DOI

10.1016/j.amjsurg.2020.12.001

Scopus ID

2-s2.0-85097458297   11 Citations

Abstract

BACKGROUND: Neighborhood adversity's impact on postoperative/adjuvant therapy delivery and overall survival (OS) is poorly described in patients with localized pancreatic cancer (PC).

METHODS: Area Deprivation Index (ADI) is a validated measure classifying neighborhood adversity. Higher ADI signifies increasing adversity. The 2013 national ADI scores were obtained from patients who completed preoperative/neoadjuvant therapy and surgery. Patients were categorized as having high (>50%) or low (a??50%) ADI.

RESULTS: Of the 224 patients, 163 (73%) had low ADI and 61 (27%) had high ADI. Adjuvant therapy was delivered to 129 (58%) patients, including 62% (101/163) with low ADI and 46% (28/61) with high ADI (pA =A 0.03). Patients with high ADI had 55% (95%CI 0.23-0.86; pA =A 0.02) decreased odds of receiving adjuvant therapy, independent of other factors. The median OS was 45 months for 129 patients who received adjuvant therapy and 31 months for 94 patients who did not receive adjuvant therapy (pA =A 0.03).

CONCLUSIONS: Patients with high ADI are less likely to receive adjuvant therapy for localized PC. Future studies should address impediments to care in patients from higher ADI neighborhoods.

Author List

Mora J, Krepline AN, Aldakkak M, Christians KK, George B, Hall WA, Erickson BA, Kulkarni N, Evans DB, Tsai S

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Ben George MD Associate Professor in the Medicine department at Medical College of Wisconsin
William Adrian Hall MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
Susan Tsai MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Chemoradiotherapy, Adjuvant
Chemotherapy, Adjuvant
Female
Healthcare Disparities
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoadjuvant Therapy
Pancreatectomy
Pancreatic Neoplasms
Prospective Studies
Residence Characteristics
Retrospective Studies
Risk Factors
Socioeconomic Factors
Vulnerable Populations