Abstract
BACKGROUND: Socioeconomic deprivation is linked to poorer outcomes in many cancers, however the impact of social deprivation on survival in resectable pancreatic and other peri-ampullary cancers appears mixed. Moreover, no studies consider the impact of social deprivation on diagnostic pathway length.
METHODS: A retrospective observational cohort study of adults with suspected periampullary cancer undergoing pancreaticoduodenectomy in England. Following surgery, patients were stratified by cancer type (PDAC, duodenal cancer, cholangiocarcinoma and ampullary cancer) and the impact of social deprivation (IMD deprivation quintiles) upon short-term survival and diagnostic pathway length analysed.
RESULTS: 648 patients from England with social deprivation data were identified, including PDAC (n = 386) and non-PDAC periampullary malignancies (n = 262). For PDAC and non-PDAC patients, there was no association between resection rate and IMD quintile (p = 0.172 and p = 0.084). For PDAC patients, no difference in neoadjuvant chemotherapy rates (p = 0.462) or 1-year survival (p = 0.052) existed across IMD quintiles.
DISCUSSION: Across England socioeconomic deprivation does not appear to relate to survival outcomes after PD for periampullary cancer, regardless of histological subtype. This suggests that pancreatic resectional centres are managing health inequality well.
DOI Link
Publication Date
2025-01-01
Publication Title
HPB
Volume
27
Issue
10
ISSN
1365-182X
Acceptance Date
2025-07-09
Deposit Date
2026-01-26
Keywords
Aged, Female, Humans, Male, Middle Aged, Ampulla of Vater/surgery, Carcinoma, Pancreatic Ductal/surgery, Cholangiocarcinoma/surgery, Common Bile Duct Neoplasms/surgery, Duodenal Neoplasms/surgery, England/epidemiology, Healthcare Disparities, Neoadjuvant Therapy, Pancreatic Neoplasms/surgery, Pancreaticoduodenectomy/mortality, Retrospective Studies, Risk Factors, Social Determinants of Health, Socioeconomic Factors, Time Factors, Treatment Outcome
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
First Page
1340
Last Page
1347
Recommended Citation
Surg-Panc-UK Study Group on behalf of AUGIS., Thorne, T., McKay, S., Pathak, S., Wilkin, R., Barrie, J., Moir, J., Roberts, K., & Aroori, S. (2025) 'Impact of social deprivation upon the preoperative pathway and early surgical outcomes after pancreatoduodenectomy for PDAC and non-PDAC periampullary cancer in England: the Surg-Panc-UK study', HPB, 27(10), pp. 1340-1347. Available at: 10.1016/j.hpb.2025.07.007
