The study did find one factor independently associated with survival rates after resection: geographic location.

Patients in the Southeast fared the worst, according to the analysis, with comparatively longer survival in the Pacific West (HR = 0.706; 95% CI, 0.628 – 0.793; P < .001), the Northeast (HR = 0.766; 95% CI, 0.667 – 0.879; P < .001), and the Midwest (HR = 0.765; 95% CI, 0.640- 0.913; P < .001).

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Therefore, corresponding author Dr. Gold said via email, “from this study, it appears that in the United States, the outcome of patients with pancreas cancer can be improved by increasing the utilization of surgical resection where appropriate. In particular, disparities in the utilization of pancreas cancer resection, particularly among African American patients, Hispanic patients, single patients, uninsured patients, and patients located in the Southeast, need to be addressed.”

Gold said that while the study’s authors aren’t sure exactly what accounts for the regional differences, they postulate that it may have to do with the available quality of care.

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“Pancreatic surgery is a complex procedure, and optimal outcomes are often achieved at experienced centers,” he said in an email to Cancer Therapy Advisor.

“Furthermore, it is thought that pancreas cancer care is best coordinated in a comprehensive multidisciplinary setting. It is conceivable that access to experienced pancreas surgical centers and centers with multidisciplinary excellence in pancreas cancer treatment vary across the country.”

The study results led Gold to conclude that “efforts to improve outcomes for pancreas cancer based on these variables are best directed at eliminating disparities in the utilization of surgical resection for pancreas cancer.”


  1. Shapiro M, Chen Q, Huang Q, et al. Associations of socioeconomic variables with resection, stage, and survival in patients with early-stage pancreatic cancer [published online ahead of print on November 18, 2015]. JAMA Surg. doi:10.1001/jamasurg.2015.4239.