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Pancreatic Cancer Multidisciplinary Clinic is Associated with Improved Treatment and Elimination of Socioeconomic Disparities

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

To identify the association between multidisciplinary clinic (MDC) management and disparities in treatment for patients with pancreatic cancer.

Background

Socioeconomic status (SES) predicts treatment and survival for pancreatic cancer. Multidisciplinary clinics (MDCs) may improve surgical management for these patients.

Methods

This is a retrospective cohort study (2010–2018) of all pancreatic cancer patients within a large, regional hospital system with a high-volume pancreatic cancer MDC. The primary outcome was receipt of treatment (surgery, chemotherapy, radiation, clinical trial participation, and palliative care); the secondary outcomes were overall survival and MDC management. Multiple logistic regressions were used for binary outcomes. Survival was analyzed using Kaplan–Meier survival analysis, Cox proportional hazards, and inverse probability of treatment weighting (IPTW).

Results

Of the 4141 patients studied, 1420 (34.3%) were managed by the MDC. MDC management was more likely for patients who were younger age, married, and privately insured, while less likely for low SES patients (all p < 0.05). MDC patients were more likely to receive all treatments, including neoadjuvant chemotherapy (OR 3.33, 95% CI 2.82–3.93), surgery (OR 1.39, 95% CI 1.15–1.68), palliative care (OR 1.21, 95% CI 1.05–1.38), and clinical trial participation (OR 3.76, 95% CI 2.86–4.93). Low SES patients were less likely to undergo surgery outside of the MDC (OR 0.47, 95% CI 0.31–0.73) but there was no difference within the MDC (OR 1.10, 95% CI 0.68–1.77). Across multiple survival analyses, low SES predicted inferior survival outside of the MDC, but there was no association among MDC patients.

Conclusion

Multidisciplinary team-based care increases rates of treatment and eliminates socioeconomic disparities for pancreatic cancer patients.

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Acknowledgement

This work was funded in part by a grant from the Shadyside Hospital Foundation in Pittsburgh, PA. The funding organization had no role in: the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. There are no non-author contributions to disclose. Richard Hoehn had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Mazen Zenati also contributed to data analysis.

Funding

Shadyside Hospital Foundation, Institutional pilot award.

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Authors and Affiliations

  1. Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Richard S. Hoehn MD, Mazen Zenati MD, PhD, Caroline J. Rieser MD, Lauren Stitt BS, Alessandro Paniccia MD & Amer H. Zureikat MD

  2. Division of Surgical Oncology, University Hospitals, Cleveland, OH, USA

    Richard S. Hoehn MD

  3. Cancer Registries, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Sharon Winters MS

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  1. Richard S. Hoehn MD
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  2. Mazen Zenati MD, PhD
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  3. Caroline J. Rieser MD
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  6. Alessandro Paniccia MD
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  7. Amer H. Zureikat MD
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Correspondence to Richard S. Hoehn MD.

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Hoehn, R.S., Zenati, M., Rieser, C.J. et al. Pancreatic Cancer Multidisciplinary Clinic is Associated with Improved Treatment and Elimination of Socioeconomic Disparities. Ann Surg Oncol 31, 1906–1915 (2024). https://doi.org/10.1245/s10434-023-14609-7

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