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31-01-2024 | Endocrine Tumors

Race and Odds of Surgery Offer in Small Bowel and Pancreas Neuroendocrine Neoplasms

Authors: Jorge G. Zarate Rodriguez, MD, Lacey Raper, BSc, Dominic E. Sanford, MD, MPH, Nikolaos A. Trikalinos, MD, MS, Chet W. Hammill, MD, MCR, FACS

Published in: Annals of Surgical Oncology | Issue 5/2024

Abstract

Background

Despite existing society guidelines, management of pancreatic (PanNEN) and small bowel (SBNEN) neuroendocrine neoplasms remains inconsistent. The purpose of this study was to identify patient- and/or disease-specific characteristics associated with increased odds of being offered surgery for PanNEN and SBNEN.

Patients and Methods

The Surveillance, Epidemiology, and End Results (SEER) Program database and the National Cancer Database (NCDB) were queried for patients with PanNEN/SBNEN. Demographic and pathologic data were compared between patients who were offered surgery and those who were not. Multivariate logistic regression was performed to identify factors independently associated with being offered surgery.

Results

In SEER, there were 3641 patients with PanNEN (54.7% were offered surgery) and 5720 with SBNEN (86.0% were offered surgery). On multivariate analysis of SEER, non-white race was associated with decreased odds of surgery offer for SBNEN [odds ratio (OR) 0.58, p < 0.001], but not PanNEN (p = 0.187). In NCDB, there were 28,483 patients with PanNEN (57.5% were offered surgery) and 42,675 with SBNEN (86.9% were offered surgery). On multivariate analysis of NCDB, non-white race was also associated with decreased odds of surgery offer for SBNEN (OR 0.61, p < 0.001) but not PanNEN (p = 0.414).

Conclusions

This study’s findings suggest that, in addition to previously reported disparities in surgical resection and surgery refusal rates, racial/ethnic disparities also exist earlier in the course of treatment, with non-white patients being less likely to be offered surgery for SBNEN but not for PanNEN; this is potentially due to discrepancies in rates of referral to academic centers for pancreas and small bowel malignancies.

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Title: Race and Odds of Surgery Offer in Small Bowel and Pancreas Neuroendocrine Neoplasms
Authors: Jorge G. Zarate Rodriguez, MD
Lacey Raper, BSc
Dominic E. Sanford, MD, MPH
Nikolaos A. Trikalinos, MD, MS
Chet W. Hammill, MD, MCR, FACS
Publication date: 31-01-2024
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-14906-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Race and Odds of Surgery Offer in Small Bowel and Pancreas Neuroendocrine Neoplasms

Abstract

Background

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusions

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