Background: Neighborhood adversity's impact on postoperative/adjuvant therapy delivery and overall survival (OS) is poorly described in patients with localized pancreatic cancer (PC).
Methods: Area Deprivation Index (ADI) is a validated measure classifying neighborhood adversity. Higher ADI signifies increasing adversity. The 2013 national ADI scores were obtained from patients who completed preoperative/neoadjuvant therapy and surgery. Patients were categorized as having high (>50%) or low (≤50%) ADI.
Results: Of the 224 patients, 163 (73%) had low ADI and 61 (27%) had high ADI. Adjuvant therapy was delivered to 129 (58%) patients, including 62% (101/163) with low ADI and 46% (28/61) with high ADI (p = 0.03). Patients with high ADI had 55% (95%CI 0.23-0.86; p = 0.02) decreased odds of receiving adjuvant therapy, independent of other factors. The median OS was 45 months for 129 patients who received adjuvant therapy and 31 months for 94 patients who did not receive adjuvant therapy (p = 0.03).
Conclusions: Patients with high ADI are less likely to receive adjuvant therapy for localized PC. Future studies should address impediments to care in patients from higher ADI neighborhoods.
Keywords: Adjuvant therapy; Area Deprivation Index; Overall survival; Pancreatic cancer; Socioeconomic status.
Copyright © 2020. Published by Elsevier Inc.