Are Lymph Node Metastases Associated With Survival in Black Patients With Pancreatic Cancer?

Autor: Fang HA; School of Medicine, University of Alabama in Birmingham, Birmingham, Alabama; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Irfan A; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Vickers SM; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Gbolahan O; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama; Department of Hematology and Oncology, University of Alabama in Birmingham, Birmingham, Alabama., Williams GR; Department of Hematology and Oncology, University of Alabama in Birmingham, Birmingham, Alabama., Outlaw D; Department of Hematology and Oncology, University of Alabama in Birmingham, Birmingham, Alabama., Wang TN; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Dudeja V; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Rose JB; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama., Reddy S; Department of Surgery, Birmingham, University of Alabama in Birmingham, Alabama. Electronic address: sreddy@uabmc.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2023 Apr; Vol. 284, pp. 143-150. Date of Electronic Publication: 2022 Dec 24.
DOI: 10.1016/j.jss.2022.11.031
Abstrakt: Introduction: Despite aggressive surgical care and systemic therapy, patients with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Recent studies show that racial disparities in outcome also exist. We sought to investigate the association lymph node (LN) metastases had with survival between Black and White patients with PDAC after resection.
Methods: Retrospective analysis of 226 PDAC patients who underwent resection at a single institution from 2010 to 2018 was performed with attention to LN metastasis and patient race. The number of patients who received chemotherapy was also evaluated.
Results: One Hundred Seventy Five (77.4%) PDAC patients were White and 51 (22.6%) were Black. 130 (59.3%) patients had LN metastasis (LN+). LN+ and LN- groups were similar in race (P = 0.93), sex (P = 0.10) and age at the time of diagnosis (P = 0.45). Patients with LN + disease were more likely to present with larger tumors (3.4 versus 2.8 cm, P = 0.02) and higher T status (P = 0.001). White and Black patients had similar rates of LN metastasis (59% versus 58.8%, P = 1.0). The median survival for LN- Black and White patients were similar (43.2 versus 30.2 mo, P = 0.82). LN + Black patients trended towards receiving more systemic therapy than White LN + patients (55% versus 42%, P = 0.10). The median survival for LN + Black patients was significantly less than LN + White patients (17.5 versus 24.6 mo, P = 0.04).
Conclusions: Black LN + PDAC patients have an inferior survival rate after resection when compared to their White counterparts. Our disparity in outcome cannot be solely explained by a difference in systemic treatment. Further investigation is warranted to determine racial differences in tumor biology or response to chemotherapy.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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