Influence of Hispanic ethnicity on outcome after resection of carcinoma ofthe head of the pancreas

BACKGROUND, Poor outcomes in Hispanic patients have been reported for tumor s at a number of sites. The authors sought to determine whether a similar p henomenon occurs in Hispanics after the resection of solid epithelial tumor s of the head of the pancreas. METHODS. Between 1983-1995, 273 patients with noncystic epithelial carcinom a of the head of the pancreas were evaluated. Resection was accomplished in 104 patients (38%); these patients were the focus of the current retrospec tive review. Of the patients who underwent resection, 26 (25%) were Hispani c and 78 (75%) were non-Hispanic. RESULTS. Although Hispanic patients tended to present at a significantly yo unger age and their serum bilirubin level was significantly higher, no othe r differences in clinical characteristics were observed. After resection, H ispanic patients had a median survival of only 11.4 months, whereas the non -Hispanic group had a median survival of 21.7 months (P = 0.009). Hispanic ethnicity, as well as age > 74 pears and jaundice at the time of presentati on also were found to be significant prognostic factors on multivariate ana lysis. Hispanic patients did not present with more advanced disease and no delays in assessment by a physician or in proceeding to surgery were observ ed. Furthermore, the rare of resection was the same in Hispanic patients an d non-Hispanic patients. Long-term survival after palliative bypass was sim ilarly worse in the Hispanic subgroup. CONCLUSIONS. Hispanic patients treated at the study center appeared to have a diminished survival after resection of a tumor of the head of the pancre as. No treatment-related factors were identified that could explain this di screpancy in outcome. Cancer 2001;91:1177-84. (C) 2001 American Cancer Soci ety.