Disparities in the Use of Chemotherapy in Patients with Resected Pancreatic Ductal Adenocarcinoma

Michael J. Wright, Heidi N. Overton, Jonathan A. Teinor, Ding Ding, Richard Burkhart, John L Cameron, Jin He, Christopher Wolfgang, Matthew J Weiss, Ammar A. Javed

Research output: Contribution to journalArticle

Abstract

Background: Introduction of effective systemic therapies for pancreatic ductal adenocarcinoma (PDAC) has demonstrated survival benefit. However, chemotherapy remains underutilized in these patients. We sought to investigate the implications of disparities on the trends in utilization of chemotherapy. Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database identified patients who underwent surgical resection for PDAC from 1998 to 2014. Clinicopathologic, demographic, racial, and geographical factors were analyzed to assess associations with receipt of chemotherapy and disease-specific survival. Results: A total of 15,585 patients were included in the study. A majority (N = 9953, 63.9%) received chemotherapy. Factors associated with poorer odds of receiving chemotherapy included older age (p < 0.001), African-American race (p = 0.003), and living in the Southwest region of the USA (p < 0.001). Married patients were at higher odds of receiving chemotherapy (all p < 0.001). Receipt of chemotherapy was independently associated with improved disease-specific survival (p < 0.001). Conclusions: Receipt of chemotherapy results in an improved survival in patients with resected PDAC. Demographic, racial, and geographic factors influence the rate of receipt of chemotherapy. Despite prior reports, these trends have not changed over the recent decades.

Original languageEnglish (US)
JournalJournal of Gastrointestinal Surgery
DOIs
StatePublished - Jan 1 2019

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Adenocarcinoma
Drug Therapy
Survival
Demography
Geography
African Americans
Epidemiology
Retrospective Studies
Databases

Keywords

  • Healthcare disparities
  • Medical oncology
  • Pancreatic neoplasms
  • Surgical oncology

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Disparities in the Use of Chemotherapy in Patients with Resected Pancreatic Ductal Adenocarcinoma. / Wright, Michael J.; Overton, Heidi N.; Teinor, Jonathan A.; Ding, Ding; Burkhart, Richard; Cameron, John L; He, Jin; Wolfgang, Christopher; Weiss, Matthew J; Javed, Ammar A.

In: Journal of Gastrointestinal Surgery, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Introduction of effective systemic therapies for pancreatic ductal adenocarcinoma (PDAC) has demonstrated survival benefit. However, chemotherapy remains underutilized in these patients. We sought to investigate the implications of disparities on the trends in utilization of chemotherapy. Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database identified patients who underwent surgical resection for PDAC from 1998 to 2014. Clinicopathologic, demographic, racial, and geographical factors were analyzed to assess associations with receipt of chemotherapy and disease-specific survival. Results: A total of 15,585 patients were included in the study. A majority (N = 9953, 63.9{\%}) received chemotherapy. Factors associated with poorer odds of receiving chemotherapy included older age (p < 0.001), African-American race (p = 0.003), and living in the Southwest region of the USA (p < 0.001). Married patients were at higher odds of receiving chemotherapy (all p < 0.001). Receipt of chemotherapy was independently associated with improved disease-specific survival (p < 0.001). Conclusions: Receipt of chemotherapy results in an improved survival in patients with resected PDAC. Demographic, racial, and geographic factors influence the rate of receipt of chemotherapy. Despite prior reports, these trends have not changed over the recent decades.",
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AU - Wright, Michael J.

AU - Overton, Heidi N.

AU - Teinor, Jonathan A.

AU - Ding, Ding

AU - Burkhart, Richard

AU - Cameron, John L

AU - He, Jin

AU - Wolfgang, Christopher

AU - Weiss, Matthew J

AU - Javed, Ammar A.

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N2 - Background: Introduction of effective systemic therapies for pancreatic ductal adenocarcinoma (PDAC) has demonstrated survival benefit. However, chemotherapy remains underutilized in these patients. We sought to investigate the implications of disparities on the trends in utilization of chemotherapy. Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database identified patients who underwent surgical resection for PDAC from 1998 to 2014. Clinicopathologic, demographic, racial, and geographical factors were analyzed to assess associations with receipt of chemotherapy and disease-specific survival. Results: A total of 15,585 patients were included in the study. A majority (N = 9953, 63.9%) received chemotherapy. Factors associated with poorer odds of receiving chemotherapy included older age (p < 0.001), African-American race (p = 0.003), and living in the Southwest region of the USA (p < 0.001). Married patients were at higher odds of receiving chemotherapy (all p < 0.001). Receipt of chemotherapy was independently associated with improved disease-specific survival (p < 0.001). Conclusions: Receipt of chemotherapy results in an improved survival in patients with resected PDAC. Demographic, racial, and geographic factors influence the rate of receipt of chemotherapy. Despite prior reports, these trends have not changed over the recent decades.

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