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Survival disparities in rural versus urban patients with pancreatic neuroendocrine tumor: A multi-institutional study from the US neuroendocrine tumor study group.

Authors :
Mirza MB
Baechle JJ
Marincola Smith P
Dillhoff M
Poultsides G
Rocha FG
Cho CS
Winslow ER
Fields RC
Maithel SK
Idrees K
Source :
American journal of surgery [Am J Surg] 2024 Jul; Vol. 233, pp. 125-131. Date of Electronic Publication: 2024 Mar 11.
Publication Year :
2024

Abstract

Background: Pancreatic Neuroendocrine Tumors (PNETs) are indolent malignancies that often have a prolonged clinical course. This study assesses disparities in outcomes between PNET patients who live in urban (UA) and rural areas (RA).<br />Methods: A retrospective cohort study was performed using the US Neuroendocrine Tumor Study Group database. PNET patients with a home zip code recorded were included and categorized as RA or UA according to the Federal Office of Rural Health Policy. Overall survival (OS) was analyzed by Kaplan-Meier method, log-rank test, and logistical regression.<br />Results: Of the 1176 PNET patients in the database, 1126 (96%) had zip code recorded. While 837 (74%) lived in UA, 289 (26%) lived in RA. RA patients had significantly shorter median OS following primary PNET resection (122 vs 149 months, p ​= ​0.01). After controlling for income, local healthcare access, distance from treatment center, ASA class, BMI, and T/N/M stage, living in a RA remained significantly associated with worse OS (HR 1.60, 95%CI 1.08-2.39, p ​= ​0.02).<br />Conclusion: Rural patients have significantly shorter OS following PNET resection compared to their urban counterparts.<br />Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest.<br /> (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1879-1883
Volume :
233
Database :
MEDLINE
Journal :
American journal of surgery
Publication Type :
Academic Journal
Accession number :
38492993
Full Text :
https://doi.org/10.1016/j.amjsurg.2024.03.003