Neighborhood Disadvantage and Postoperative Outcomes: Study of PDAC Patients in a Tertiary Urban Center

Document Type

Conference Proceeding

Publication Date

3-11-2025

Publication Title

Ann Surg Oncol

Keywords

Oncology, Surgery

Abstract

Introduction: Lower socioeconomic status (SES) has been linked to worse cancer outcomes, higher mortality rates and lower survival probabilities. The Area Deprivation Index (ADI), a validated measure of neighborhood-level SES, captures socioeconomic disparities and provides a better understanding of how social determinants of health impact cancer care and outcomes. Our Multidisciplinary Pancreas Clinic – comprising nurse navigation, medical, surgical, radiation oncologists, psychologists, and nutritionists – aims to provide equitable and efficient care to all patient demographics in our integrated health system. We sought to explore the association between neighborhood disadvantage and postoperative outcomes in patients undergoing pancreatectomy for Pancreatic Ductal Adenocarcinoma (PDAC). Methods: A retrospecitve analysis of PDAC patients diagnosed between 2016 and 2024 was conducted. To measure neighborhood disadvantage, the cohort was categorized into ADI tertiles: Q1 (1-44), Q2 (45-74) and Q3 (75-100) with 1 and 100 being the least and most disadvantaged groups, respectively. Logistic Regression and Kaplan-Meier method were used to assess the association between ADI and our outcomes of interest which included post-surgical pancreatic complications, unplanned readmission with 30 days and mortality. Results: 413 patients underwent a pancreatectomy for PDAC between 2013 and 2024. The mean age at diagnosis was 64.9 ± 10 years and median ADI was 61. Patients in Q3 (highest disadvantage) were almost 3 times more likely to be readmitted within 30 days after surgery when compared to those in Q1 (OR: 2.891, 95% CI [1.02; 7.76], p-value= 0.04). There were no significant differences between ADI groups in pancreatic fistula, gastroparesis, post-surgical bleeding (all p>0.05) and in mortality (log-Rank p=0.551). Conclusions: Patients from more disadvantaged neighborhoods, as indicated by higher ADI, had significantly higher 30-day readmission rates following surgery. These results highlight the need to implement targeted strategies that address and improve social determinants of health, and its role in affecting post-surgical outcomes, for it is becoming increasingly more evident that their role is nearly as important in oncologic care and postoperative recovery.

Volume

32

First Page

S215

Last Page

S216

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