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因胰腺腺癌接受胰十二指肠切除术的患者中,30天并发症发生率在不同种族间并无差异。

Thirty-day complication rates do not differ by race among patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma.

作者信息

Mitsakos Anastasios T, Dennis Samuel O, Parikh Alexander A, Snyder Rebecca A

机构信息

Department of Surgery, Division of Surgical Oncology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.

Department of Public Health, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.

出版信息

J Surg Oncol. 2021 Mar;123(4):970-977. doi: 10.1002/jso.26383. Epub 2021 Jan 26.

Abstract

BACKGROUND AND OBJECTIVES

Black patients with pancreatic ductal adenocarcinoma (PDAC) are less likely to receive multimodality treatment and have worse survival compared to White patients. However, little is known regarding racial differences in postoperative outcomes. The primary aim of this study was to determine if 30-day complication rates following pancreaticoduodenectomy (PD) differ by race.

METHODS

A retrospective cohort study of patients who underwent PD for PDAC from 2014 to 2016 within the ACS-NSQIP pancreatectomy-specific data set was performed. Primary outcomes were 30-day pancreas-specific and overall major complications.

RESULTS

A total of 6936 patients were identified, including 91.4% (N = 6337) White and 8.6% (N = 599) Black. Pathologic stage and rates of neoadjuvant therapy were similar among Whites and Blacks. Rates of pancreas-specific (23.9% vs. 23.1%, p = .88) and major postoperative complications (39.2% vs. 39.9%, p = .55) were similar between Whites and Blacks. By multivariable regression analysis, there was no association between race and odds of pancreas-specific complications (odds ratio [OR] 1.10, 95% confidence interval [CI] 0.89-1.37) or overall major complications (OR 1.13, 95% CI 0.95-1.36).

CONCLUSIONS

Among patients undergoing PD for PDAC, Black race is not associated with increased pancreas-specific or overall 30-day postoperative complications. Short-term postoperative outcomes do not appear to explain the increase in pancreatic cancer mortality among Black patients.

摘要

背景与目的

与白人患者相比,患有胰腺导管腺癌(PDAC)的黑人患者接受多模式治疗的可能性较小,且生存率更低。然而,关于术后结果的种族差异知之甚少。本研究的主要目的是确定胰十二指肠切除术(PD)后30天并发症发生率是否因种族而异。

方法

对2014年至2016年在ACS-NSQIP胰腺切除术特定数据集中因PDAC接受PD的患者进行回顾性队列研究。主要结局是30天胰腺特异性和总体主要并发症。

结果

共确定6936例患者,其中91.4%(N = 6337)为白人,8.6%(N = 599)为黑人。白人和黑人的病理分期及新辅助治疗率相似。白人和黑人之间的胰腺特异性并发症发生率(23.9%对23.1%,p = 0.88)和术后主要并发症发生率(39.2%对39.9%,p = 0.55)相似。通过多变量回归分析,种族与胰腺特异性并发症发生率(优势比[OR] 1.10,95%置信区间[CI] 0.89 - 1.37)或总体主要并发症发生率(OR 1.13,95% CI 0.95 - 1.36)之间无关联。

结论

在因PDAC接受PD的患者中,黑人种族与胰腺特异性或总体30天术后并发症增加无关。术后短期结果似乎无法解释黑人患者胰腺癌死亡率的增加。

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