Regional disparities affect treatment and survival of patients with intrahepatic cholangiocarcinoma—A Texas Cancer Registry analysis

摘要: Background Intrahepatic cholangiocarcinoma (ICC) is often diagnosed at advanced stage and few patients qualify for resection. Effects of barriers to access on outcomes are unknown. We hypothesized that income rural residence account delays in treatment decreased survival. Methods Texas Cancer Registry was queried ICC from 2000 2008. Median household (MHI) urban/rural status were analyzed. Regression analyses performed (1) time-to- (TTT), (2) overall survival (OS). Results Among 1,089 patients, 20.2% resided areas MHI ranged $24,497–$81,113/year. Primary included surgery 9.5%, radiation 5.4% chemotherapy 21.0%. TTT 29 (range 0–235) days. Patients low-income less likely receive (below median MHI, 29.7% vs. above 37.5%%; P = 0.007). associated with (per $10,000/year: hazard ratio (HR) = 1.05; 95% CI: 1.01–1.09). Adjusting stage, OS HR = 0.97; 95%CI: 0.94–0.99). Rural neither nor OS. Conclusion Overall rates low. Regional income, not urbanization independent stage. Further research needed determine how regional prosperity relates care access. J. Surg. Oncol. 2014; 110:416–421. © 2014 Wiley Periodicals, Inc.