Impact of Environmental Quality on Pancreatic Cancer Outcomes Post Pancreatoduodenectomy: A Retrospective Cohort Study.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-05-31 DOI:10.1007/s12029-025-01254-4

Abdullah Khalid, Victoria Aveson, Shamsher A Pasha, Lyudmyla Demyan, Oliver Standring, Elliot Newman, Daniel A King, Danielle DePeralta, Sepideh Gholami, Matthew J Weiss, Marcovalerio Melis

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引用次数: 0

Abstract

Introduction: The Environmental Quality Index (EQI), a composite measure of county-level environmental burden, has been linked to cancer incidence and disease progression. We evaluated the association between EQI and clinical characteristics and outcomes among patients undergoing pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

Methods: We conducted a retrospective cohort study of PDAC patients who underwent PD between 2014 and 2023. Patients were stratified into low, moderate, or high EQI groups. Multinomial regression models were used to assess associations between EQI levels and clinical variables, using the low EQI group as the reference.

Results: Among the 137 patients with PDAC who underwent PD, 37 (27.1%) were in the low, 42 (30.6%) in the moderate, and 58 (42.3%) in the high EQI groups. The study identified significant associations in high EQI groups: race (minority vs. white patients: RR 2.44, p = 0.044); diabetes mellitus prevalence (RR 3.12, 95% CI 1.30-7.49, p = 0.011), tumor size > 5 cm (RR 1.53, p = 0.048), history of other types of cancer (RR 1.64, p = 0.038), longer time-to-treatment (RR 1.96, p = 0.041), and ICU stay > 3 days (RR 1.95, p = 0.013), compared to the low EQI group. No significant differences were observed in severe post-operative complications, mortality rates, or median overall survival across groups (mOS: 20.2 months for low, 15.2 months for moderate, and 14.2 months for high EQI, respectively, p = 0.210).

Conclusion: Patients residing in areas with poor environmental quality had higher comorbidity burden and delays in treatment, though EQI was not significantly associated with surgical or survival outcomes.

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环境质量对胰十二指肠切除术后胰腺癌预后的影响：一项回顾性队列研究

环境质量指数（EQI）是县级环境负担的综合衡量指标，与癌症发病率和疾病进展有关。我们评估了胰管腺癌（PDAC）患者行胰十二指肠切除术（PD）的EQI与临床特征和预后之间的关系。方法：我们对2014年至2023年间接受PD治疗的PDAC患者进行了回顾性队列研究。患者被分为低、中、高EQI组。以低EQI组为参照，采用多项回归模型评估EQI水平与临床变量之间的关系。结果：137例接受PD治疗的PDAC患者中，低EQI组37例（27.1%），中等EQI组42例（30.6%），高EQI组58例（42.3%）。该研究确定了高EQI组的显著相关性：种族（少数族裔与白人患者：RR 2.44, p = 0.044）；与低EQI组相比，糖尿病患病率（RR 3.12, 95% CI 1.30 ~ 7.49, p = 0.011）、肿瘤大小（RR 1.53, p = 0.048）、其他类型肿瘤病史（RR 1.64, p = 0.038）、治疗时间（RR 1.96, p = 0.041）、ICU住院时间（RR 1.95, p = 0.013）均显著高于低EQI组。各组间在严重术后并发症、死亡率或中位总生存期方面均无显著差异（低EQI组的生存期分别为20.2个月、中等EQI组为15.2个月、高EQI组为14.2个月，p = 0.210）。结论：生活在环境质量较差地区的患者有较高的合并症负担和治疗延误，但EQI与手术或生存结果无显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.