Pancreatic ductal adenocarcinoma: disparate outcomes linked to quality of care

  • Heller DR & al.
  • JAMA Surg
  • 4 Dec 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A retrospective analysis finds better survival among black patients with pancreatic ductal adenocarcinoma (PDAC) than white patients when quality of care is similar.

Why this matters

  • Black patients should experience better outcomes if access to care is improved.

Study design

  • Cohort study based on the National Cancer Database (n=278,936; 83.3% white; 12.6% black).
  • Funding: None disclosed.

Key results

  • Black patients were younger at presentation (mean age, 66.2 vs 69.1 years; P<.001 were more likely to have advanced disease stage iii vs p comorbidities comorbidity index score and be treated at an academic or tertiary care center>
  • Among stage I patients, black and white patients had similar odds of undergoing surgery, but black patients with stage II disease were less likely to undergo surgery than their white counterparts (52.2% vs 60.2%; P<.001>
  • Black patients with advanced disease were less likely to receive chemotherapy, particularly in stage IV (51.0% vs 55.5%; P<.001>
  • Black patients had reduced survival (HR, 1.04; 95% CI, 1.02-1.05).
  • When controlling for clinical stage and treatment, black patients had better survival (HR, 0.94; 95% CI, 0.93-0.96).

Limitations

  • Retrospective analysis.