Racial disparities in outcomes among Black and White patients with PDAC persist and are not explainable by differences in systemic treatment.
Patients with pancreatic ductal adenocarcinoma (PDAC) tend to receive poor prognoses despite aggressive surgical care and systemic therapy. Racial disparities in outcomes are also present among patients with this condition. This study, published in the Journal for Surgical Research, investigates the association between lymph node metastases and survival between Black and White Patients with PDAC after resection. The study uses a retrospective analysis of 226 PDAC patients who underwent resection at a single institution between 2010 and 2018. Special attention was paid to lymph node metastases and race.
Of the patients in the study, 175 were White and 51 were Black. Lymph node metastasis was found in 130 patients (59.3%), and the group with lymph node metastasis and the group without metastasis had a similar breakdown regarding race, sex, and age at the time of diagnosis. Patients with lymph node metastasis were more likely to present with larger tumors and higher T status. The median survival rate for Black and White patients without lymph node metastasis was similar. Black patients with lymph node metastasis trended towards receiving more systemic therapy compared to White patients with lymph node metastasis. The overall median survival for Black patients with lymph node metastases was much lower than that of White patients, at 17.5 months for Black patients vs. 24.6 months for White patients.
Overall, Black patients with PDAC who experienced lymph node metastasis had an inferior survival rate after resection, although other statistics related to treatment frequency and other factors varied. As a result of these variations, disparities in outcome are not explainable solely by a difference in systemic treatment. Additional research is needed to determine whether racial differences in tumor biology or response to chemotherapy are relevant to explain these disparities.
Fang, H. A., Irfan, A., Vickers, S. M., Gbolahan, O., Williams, G. R., Outlaw, D., Wang, T. N., Dudeja, V., Rose, J. B., & Reddy, S. (2022). Are Lymph Node Metastases Associated With Survival in Black Patients With Pancreatic Cancer? Journal of Surgical Research, 284, 143-150. https://doi.org/10.1016/j.jss.2022.11.031