ArticleAnnals of surgical oncology2023
Impact of Food Insecurity on Outcomes Following Resection of Hepatopancreaticobiliary Cancer.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of food insecurity on chronic liver disease: A systematic review of the literature.Hepatology communications · 2025Pooled it
- Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Food and Nutrition Insecurity in Cancer Survivorship: A Global Scoping Review.Cancer medicine · 2026Article
- Food Security and Malnutrition Status in Patients with Cancer: An Australian Cross-Sectional Survey.Nutrients · 2026Observational
- Social Determinants of Health and 30-Day Mortality After Inpatient Elective Surgery.JAMA network open · 2026Article
- Prevalence and Impact of Food Insecurity in Patients Undergoing Pulmonary Function Testing: A Cross-Sectional Study.CHEST pulmonary · 2025Article
- Review
- State-Level Tax Policy, Cancer Screening, and Mortality Rates in the US.JAMA network open · 2025Article
- Days at Home After Cancer Surgery: Impact of Area Deprivation and Association with Long-Term Outcomes.Annals of surgical oncology · 2025Article
- Social Determinants of Health Associated with Cholangiocarcinoma Risk in High-Risk Areas of Thailand: A Case-Control Study.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- New trends in diagnosis and management of gallbladder carcinoma.World journal of gastrointestinal oncology · 2024Review
- Association of State and Local Social and Public Health Spending With Cancer Incidence and Mortality.Cancer control : journal of the Moffitt Cancer CenterArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFood insecurity (FI) may predispose individuals to suboptimal nutrition, leading to chronic disease and poor health outcomes. We sought to assess the impact of county-level FI on postoperative outcomes among patients undergoing resection of hepatopancreaticobiliary (HPB) cancer.
methodsPatients who were diagnosed with HPB cancer between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Data on annual county-level FI were obtained from the Feeding America: Mapping the Meal Gap report and were categorized into tertiles. Textbook outcome was defined as no extended length of stay, perioperative complications, 90-day readmission, and 90-day mortality. Multiple logistic regression and Cox regression models were used to assess outcomes and survival relative to FI.
resultsAmong 49,882 patients (hepatocellular: n = 11,937, 23.9%; intrahepatic cholangiocarcinoma: n = 2111, 4.2%; extrahepatic cholangiocarcinoma: n = 4047, 8.1%; gallbladder: n = 2853, 5.7%; pancreatic: n = 28,934, 58.0%), 6702 (13.4%) patients underwent a surgical resection. Median age was 75 years (interquartile range 69-82), and most patients were male (n = 25,767, 51.7%) and self-identified as White (n = 36,381, 72.9%). Overall, 5291 (10.6%) and 39,664 (79.5%) individuals resided in low or moderate FI counties, respectively, while 4927 (9.8%) patients resided in high FI counties. Achievement of textbook outcome (TO) was 56.3% (n = 6702). After adjusting for competing risk factors, patients residing in high FI counties had lower odds to achieve a TO versus individuals living in low FI counties (odds ratio 0.69, 95% confidence interval [CI] 0.54-0.88, p = 0.003). In addition, patients residing in moderate and high FI counties had a greater risk of mortality at 1- (referent, low, moderate: hazard ratio [HR] 1.09, 95% CI 1.05-1.14; high: HR 1.14, 95% CI 1.08-1.21), 3- (referent, low, moderate: HR 1.09, 95% CI 1.05-1.14; high: HR 1.14, 95% CI 1.08-1.21), and 5- (referent, low, moderate: HR 1.05, 95% CI 1.01-1.09; high: HR 1.07, 95% CI 1.02-1.13) years versus individuals from low FI counties.
conclusionsFI was associated with adverse perioperative outcomes and long-term survival following resection of an HPB malignancy. Interventions directed towards mitigating nutritional inequities are needed to improve outcomes among vulnerable HPB populations.
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