Initiation of adjuvant therapy following surgical resection of pancreatic ductal adenocarcinoma (PDAC): Are patients from rural, remote areas disadvantaged?

Journal of Surgical Oncology
Kimberly A BertensFlavio G Rocha

Abstract

Although race and socioeconomic status have been shown to affect outcomes in pancreatic ductal adenocarcinoma (PDAC), the impact of rural residence on the delivery of adjuvant therapy (AT) has not been studied. Patients with resected PDAC were identified using the National Cancer Database (NCDB). Individuals were classified as living in a metro area, urban/rural adjacent to a metro area (URA), and urban/rural remote (URR) area. Multivariate logistic regression was used to assess geographic inhabitance as a predictor of receiving AT. A total of 32 521 individuals who underwent pancreatectomy for PDAC were identified. Univariate analysis demonstrated individuals in URR areas were less likely to receive adjuvant chemotherapy (ACT) than those living in URA or metro areas (55.3% vs 55.6% vs 58.8%, P = 0.011). However on multivariate analysis URR inhabitance was no longer a predictor of ACT (OR = 0.911 P = 0.125) or ART (OR = 0.953 P = 0.462). Cox proportional hazard modeling demonstrated URR inhabitance remained independently associated with poor OS (HR 1.076; 95% CI [1.008, 1.149], P < 0.029). URR inhabitance does not impact access to AT, however it is independently associated with a decreased OS. Attention must be focused on optim...Continue Reading

References

Sep 25, 2001·American Journal of Preventive Medicine·M M CaseyJ M Klingner
Nov 22, 2001·Lancet·J P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Apr 12, 2002·The New England Journal of Medicine·John D BirkmeyerDavid E Wennberg
Dec 4, 2003·JAMA : the Journal of the American Medical Association·John D BirkmeyerDavid C Goodman
Mar 19, 2004·The New England Journal of Medicine·John P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Nov 11, 2005·The American Journal of Gastroenterology·Laura FazioSteven Gallinger
Aug 2, 2007·Annals of Surgery·Karl Y BilimoriaMark S Talamonti
Dec 5, 2009·Journal of Epidemiology and Community Health·Y HaoE M Ward
Jun 12, 2012·Medical Oncology·Steve R MartinezRichard J Bold
Jan 15, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Juan W ValleMarkus W Büchler
May 20, 2015·The Australian Journal of Rural Health·Talar W MarkossianChristopher Senkowski
Mar 26, 2016·Surgical Oncology Clinics of North America·Daneng Li, Eileen M O'Reilly

❮ Previous
Next ❯

Citations

Oct 1, 2018·Oncology Research and Treatment·Julia Benzel, Volker Fendrich
Jul 28, 2020·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Joel E SegelNiraj J Gusani
Aug 28, 2020·Annals of Surgical Oncology·Elizabeth J OleckiChan Shen
Sep 30, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Danielle K DePeraltaJason B Fleming
Mar 27, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ahmad HamadAslam Ejaz

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carcinoma, Ductal

Ductal carcinoma is a malignant neoplasm involving the ductal systems of any of a number of organs, such as the mammary glands, pancreas, prostate or lacrimal gland. Discover the latest research on ductal carcinoma here.

Related Papers

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
Jonathan M LoreeWinson Y Cheung
Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Olga KantorMarshall S Baker
HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Akhil ChawlaJohn B Ammori
© 2022 Meta ULC. All rights reserved