Interaction of race and pathology for neuroendocrine tumors: Epidemiology, natural history, or racial disparity?

Background and Objectives Although minority race has been associated with worse cancer outcomes, the interaction of race with pathologic variables and outcomes of patients with gastroenteropancreatic neuroendocrine tumors (GEP‐NETs) is not known. Methods Patients from the US Neuroendocrine Study Gro...

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Bibliographic Details
Published in:Journal of surgical oncology 2019-11, Vol.120 (6), p.919-925
Main Authors: DePalo, Danielle K., Lee, Rachel M., Lopez‐Aguiar, Alexandra G., Gamboa, Adriana C., Rocha, Flavio, Poultsides, George, Dillhoff, Mary, Fields, Ryan C., Idrees, Kamran, Nathan, Hari, Abbott, Daniel, Maithel, Shishir K., Russell, Maria C.
Format: Article
Language:English
Subjects:
Black or African American - statistics & numerical data
Cancer surgery
Female
Follow-Up Studies
Healthcare Disparities
Humans
Intestinal Neoplasms - epidemiology
Intestinal Neoplasms - pathology
lymph node positivity
Male
Middle Aged
Neuroendocrine tumors
Neuroendocrine Tumors - epidemiology
Neuroendocrine Tumors - pathology
pancreas
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - pathology
Prognosis
Racial differences
racial disparities
Retrospective Studies
small bowel
Small intestine
Stomach Neoplasms - epidemiology
Stomach Neoplasms - pathology
Survival Rate
White People - statistics & numerical data
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Summary:Background and Objectives Although minority race has been associated with worse cancer outcomes, the interaction of race with pathologic variables and outcomes of patients with gastroenteropancreatic neuroendocrine tumors (GEP‐NETs) is not known. Methods Patients from the US Neuroendocrine Study Group (2000‐2016) undergoing curative‐intent resection of GEP‐NETs were included. Given few patients of other races, only Black and White patients were analyzed. Results A total of 1143 patients were included. Median age was 58 years, 49% were male, 14% Black, and 86% White. Black patients were more likely to be uninsured (7% vs 2%, P = .011), and to have symptomatic bleeding (13% vs 7%, P = .009), emergency surgery (7% vs 3%, P = .006), and positive lymph nodes (LN) (47% vs 36%, P = .021). However, Black patients had improved 5‐year recurrence‐free survival (RFS) (90% vs 80%, P = .008). Quality of care was comparable between races, seen by similar LN yield, R0 resections, postoperative complications, and need for reoperation/readmission (all P > .05). While both races were more likely to have pancreas‐NETs, Black patients had more small bowel‐NETs (22% vs 13%, P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25662