Impact of ethnicity on outcome in pancreatic carcinoma.
BACKGROUND
Ethnicity is an important factor known to impact the biology and outcome of many cancers. In pancreatic cancer, African Americans are thought to have a higher incidence and poorer prognosis than Whites.


METHODS
A total 645 pancreatic cancer patients were identified in the database, of which, 530 patients were eligible for this study and retained for the statistical analysis. Of the 530 patients, 137 (25.8%) were Blacks, 393 (74.2%) were Whites, 275 (51.9%) were males and 255 (48.1) were females. Ages ranged from 21 to 93 years with values of 62.3+/-13.3 years, 64.2+/-11.6 years, 63.1+/-10.9 and 64.3+/-13.3 (mean+/-SD) for Blacks, Whites, males, and females, respectively. Overall, 132 patients out of 415 (31.8%) were seen in stage I, 61 (14.7%) in stage II, 105 (25.3%) in stage III, 117 (28.2%) in stage IV, while 115 patients (21.7%) had missing stage.


RESULTS
There were no significant differences between Blacks and Whites with respect to distributions across stages (P=0.422). Adenocarcinoma was the most common histology in both ethnicities with poor differentiation in 47.4% of Blacks and 57.0% of Whites. Overall, 125 (23.6%) received surgery alone, 54 (10.2%) surgery with chemotherapy, 5 (0.9%) surgery with external radiation therapy, 10 (1.9%) external radiation therapy alone, 68 (12.8%) chemotherapy alone, 58 (10.9%) chemo-external radiation therapy, and 210 (39.6%) no therapy. Overall, only 22 patients survived at 5-yr (4.2%). Median survival was 8.0 months for Blacks (95% CI: 6.4-10.2) and 8.1 months for Whites (95% CI: 7.1-9.7) and there was no significant difference in survival between Blacks and Whites (P=0.971). There were more survivors in females (43/255, 16.9%) than in males (25/275, 9.1%; P=0.009), and females had significantly greater survival times as compared to males (P=0.022).


CONCLUSIONS
Pancreatic cancer is a disease of both ethnicities with a slight male predominance among Whites and female predominance among Blacks. We did not find any significant difference in the treatment specific outcome and survival between Blacks and Whites.
Saif
Muhammad Wasif
MW
University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA. wasif.saif@ccc.uab.edu
Sviglin
Helena
H
Carpenter
Mark
M
D000230:Adenocarcinoma / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology / Q000628:therapy*; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012727:Sex Characteristics; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People