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 26 May 2018

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News

Survival in patients with pancreatic cancer remains low

Treatment factors are related to survival time in pancreatic cancer, although there is racial disparity in therapies, reports September's American Journal of Surgery.

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Dr Mohamad Eloubeidi and investigators performed a population-based study of patients from the deep South of the United States.

The investigative team evaluated the survival rate of patients with pancreatic cancer.

The team analyzed prognostic factors influencing pancreatic cancer survival using the Alabama Statewide Cancer Registry.

The investigators determined whether race/ethnicity is an independent determinant of outcomes in patients with pancreatic cancer.

The team included eligible participants diagnosed with pancreatic cancer from 1996 to 2000 and reported to the Alabama Statewide Cancer Registry.

Survival time was calculated from time of diagnosis to death for pancreatic cancer deaths.

The team also calculated survival time from the time of diagnosis to date of last contact or death from other causes for censored participants.

Risk factors associated with survival were assessed with the Kaplan-Meier survival method and the log-rank test.

The median survival time for all patients was less than 5 months
American Journal of Surgery

Demographic, tumor, and treatment variables were assessed using the Cox proportional hazards model.

The investigators evaluated 2230 patients, whose median age at diagnosis was 71 years with a male to female ratio of approximately 1 to 1.

Of these patients, 73% were white, and 27% were black.

The distribution by stage was 13% localized disease, 30% regional, 35% distant, and 23% unstaged.

The median survival time for all patients was less than 5 months.

The investigators noted that patients who underwent surgical treatment were less likely to die of pancreatic cancer.

Similarly, patients who underwent either chemotherapy or radiation therapy had improved survival rates.

Across all stages, the team observed that black patients were significantly less likely to receive chemotherapy compared with white patients.

These patients were less likely to receive surgical intervention.

When examining patients who were offered their therapy of choice but refused, the team found that a greater proportion of black patients refused therapies.

For chemotherapy, 4% of black patients refused therapy versus 2% of white patients.

The team noted that for radiation, and 9% of black patients refused therapy versus 3% of white patients.

The Cox proportional hazard model showed no effect of race on overall survival time while controlling for stage at presentation.

In addition, the investigators observed no effect of race on survival controlling for type of therapy received, age at diagnosis, and site of primary tumor.

Dr Eloubeidi's team concluded, “Survival in patients with pancreatic cancer remains dismal.”

“Tumor characteristics and treatment factors are related directly to survival time in patients with pancreatic cancer.”

“Black patients were less likely to receive therapy but also were more likely to refuse the indicated therapy.”

“Factors leading to racial disparity in the treatment of pancreatic cancer warrant further investigation.”

Am J Surg 2006: 192(3): 322-9
29 August 2006

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