PMID- 38356257
OWN - NLM
STAT- Publisher
LR  - 20240215
IS  - 2508-5859 (Electronic)
IS  - 2508-5859 (Linking)
DP  - 2024 Feb 15
TI  - Associations between income and survival in cholangiocarcinoma: A comprehensive 
      subtype-based analysis.
LID - 10.14701/ahbps.23-136 [doi]
AB  - BACKGROUNDS/AIMS: Socioeconomic determinants of health are incompletely 
      characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status 
      influences initial treatment decisions and survival outcomes in patients with 
      CCA, additionally performing multiple sub-analyses based on anatomic location of 
      the primary tumor. METHODS: Observational study using the 2018 submission of the 
      Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 
      patients from 2004-2015 with a CCA were separated based on median household 
      income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th 
      percentile of MHI) groups. Seventy-three percent of patients had complete follow 
      up data, and were included in survival analyses. Survival and treatment outcomes 
      were calculated using R-studio. RESULTS: When all cases of CCA were included, the 
      high-income group was more likely than the low-income to receive surgery, 
      chemotherapy, and local tumor destruction modalities. Initial treatment modality 
      based on income differed significantly between tumor locations. Patients of lower 
      income had higher overall and cancer-specific mortality at 2 and 5 years. 
      Non-cancer mortality was similar between the groups. Survival differences 
      identified in the overall cohort were maintained in the intrahepatic CCA 
      subgroup. No differences between income groups were noted in cancer-specific or 
      overall mortality for perihilar tumors, with variable differences in the distal 
      cohort. CONCLUSIONS: Lower income was associated with higher rates of 
      cancer-specific mortality and lower rates of surgical resection in CCA. There 
      were significant differences in treatment selection and outcomes between 
      intrahepatic, perihilar, and distal tumors. Population- based strategies aimed at 
      identifying possible etiologies for these disparities are paramount to improving 
      patient outcomes.
FAU - Geng, Calvin X
AU  - Geng CX
AUID- ORCID: 0000-0001-7583-9191
AD  - Department of Medicine, University of Virginia, Charlottesville, VA, USA.
FAU - Gudur, Anuragh R
AU  - Gudur AR
AUID- ORCID: 0000-0002-1348-9816
AD  - Department of Medicine, University of Virginia, Charlottesville, VA, USA.
FAU - Kadiyala, Jagannath
AU  - Kadiyala J
AUID- ORCID: 0009-0001-7583-6107
AD  - Department of Medicine, University of Virginia, Charlottesville, VA, USA.
FAU - Strand, Daniel S
AU  - Strand DS
AUID- ORCID: 0000-0001-5573-6291
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, University 
      of Virginia, Charlottesville, VA, USA.
FAU - Shami, Vanessa M
AU  - Shami VM
AUID- ORCID: 0000-0001-7528-5141
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, University 
      of Virginia, Charlottesville, VA, USA.
FAU - Wang, Andrew Y
AU  - Wang AY
AUID- ORCID: 0000-0002-6519-7882
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, University 
      of Virginia, Charlottesville, VA, USA.
FAU - Podboy, Alexander
AU  - Podboy A
AUID- ORCID: 0000-0001-9353-4965
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, University 
      of Virginia, Charlottesville, VA, USA.
FAU - Le, Tri M
AU  - Le TM
AUID- ORCID: 0009-0001-8498-6414
AD  - Division of Hematology and Oncology, Department of Medicine, University of 
      Virginia, Charlottesville, VA, USA.
FAU - Reilley, Matthew
AU  - Reilley M
AUID- ORCID: 0000-0002-4725-0459
AD  - Division of Hematology and Oncology, Department of Medicine, University of 
      Virginia, Charlottesville, VA, USA.
FAU - Zaydfudim, Victor
AU  - Zaydfudim V
AUID- ORCID: 0000-0003-4572-7038
AD  - Division of Surgical Oncology, Department of Surgery, University of Virginia, 
      Charlottesville, VA, USA.
FAU - Buerlein, Ross C D
AU  - Buerlein RCD
AUID- ORCID: 0000-0002-1033-9783
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, University 
      of Virginia, Charlottesville, VA, USA.
LA  - eng
PT  - Journal Article
DEP - 20240215
PL  - Korea (South)
TA  - Ann Hepatobiliary Pancreat Surg
JT  - Annals of hepato-biliary-pancreatic surgery
JID - 101698342
OTO - NOTNLM
OT  - Cholangiocarcinoma
OT  - Social determinants of health
EDAT- 2024/02/15 06:43
MHDA- 2024/02/15 06:43
CRDT- 2024/02/15 01:23
PHST- 2023/10/31 00:00 [received]
PHST- 2024/01/09 00:00 [revised]
PHST- 2024/01/14 00:00 [accepted]
PHST- 2024/02/15 06:43 [medline]
PHST- 2024/02/15 06:43 [pubmed]
PHST- 2024/02/15 01:23 [entrez]
AID - ahbps.23-136 [pii]
AID - 10.14701/ahbps.23-136 [doi]
PST - aheadofprint
SO  - Ann Hepatobiliary Pancreat Surg. 2024 Feb 15. doi: 10.14701/ahbps.23-136.