Abstract 1172: Disparities in pancreatic ductal adenocarcinoma - the significance of Hispanic ethnicity, by subgroup analysis, and treatment facility on clinical outcomes
Authors: Andrea N. Riner, Patrick W. Underwood, Kai Yang, Kelly M. Herremans, Miles E. Cameron, Srikar Chamala, Peihua Qiu, Thomas George, Jennifer Permuth, Nipun B. Merchant, Jose G. Trevino
Journal: Cancer Research (2020)

Abstract Background: Disparities exist among patients with pancreatic ductal adenocarcinoma (PDAC). Non-White race is regarded as a negative predictor of expected treatment and overall survival. Data suggest Academic Research Programs (ARP) provide better outcomes for minorities, but ethnic/minority outcomes are underreported. We sought to evaluate outcomes among diverse patients with PDAC, with a focus on Hispanic subgroups. We hypothesize that outcomes among racially/ethnically diverse PDAC patients may be influenced by treatment facility. Methods: The National Cancer Database was used to identify 170,327 patients diagnosed with PDAC between 2004 and 2015. Cox proportional-hazard regression was used to compare survival between race/ethnic groups across facilities. Results: In unadjusted models, compared to Non-Hispanic Whites (NHW), Non-Hispanic Blacks (NHB) had the worst overall survival (HR=1.05, 95%CI:1.03-1.06, p&amp;lt;0.001) and Hispanics had the best overall survival (HR=0.92, 95%CI:0.90-0.94, p&amp;lt;0.001). After controlling for socioeconomic and clinical covariates, NHB (HR=0.95, 95%CI:0.93-0.96, p&amp;lt;0.001) had better overall survival compared to NHW, and Hispanics continued to have the best comparative outcomes (HR=0.84, 95%CI:0.82-0.86, p&amp;lt;0.001). Amongst Hispanics, Dominicans and South/Central Americans lived the longest, at 10.25 and 9.82 months, respectively. The improved survival in Hispanics was most pronounced at ARP (HR=0.80, 95%CI:0.77-0.84, p&amp;lt;0.001) and Integrated Network Cancer Programs (HR=0.78, 95%CI:0.73-0.84, p&amp;lt;0.001). NHB had improved survival over NHW at Comprehensive Community Care Programs (HR=0.96, 95%CI:0.93-0.98, p=0.002) and ARP (HR=0.96, 95%CI:0.94-0.98, p=0.001), which was influenced by income, education, and surgical resection. Conclusion: Hispanics with PDAC have better overall survival compared to Non-Hispanics at all facilities, but most profoundly at ARP and INCP. Dominicans and South/Central Americans in particular have significantly improved survival at ARP. Survival was improved at ARP for all populations. NHB had improved overall survival at higher volume centers, but this was dependent upon income, education, and surgical resection. Citation Format: Andrea N. Riner, Patrick W. Underwood, Kai Yang, Kelly M. Herremans, Miles E. Cameron, Srikar Chamala, Peihua Qiu, Thomas George, Jennifer Permuth, Nipun B. Merchant, Jose G. Trevino. Disparities in pancreatic ductal adenocarcinoma - the significance of Hispanic ethnicity, by subgroup analysis, and treatment facility on clinical outcomes [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1172.