Factors associated with inability to return to intended oncologic treatment in pancreatic cancer.

Autor: Mickel TA; Department of Surgery, Medical University of South Carolina, Clinical Sciences Building Suite 420, 96 Jonathan Lucas St, Charleston, SC, 29425, USA. Electronic address: mickel@musc.edu., Kutlu OC; Department of Surgery, University of Miami, 1120 NW 14(th) St f4, Miami, FL, 33136, USA. Electronic address: okutlu@med.miami.edu., Silberfein EJ; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: ejs@bcm.edu., Hsu C; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: Cary.Hsu@bcm.edu., Chai CY; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: Christy.Chai@bcm.edu., Fisher WE; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: wfisher@bcm.edu., Van Buren G 2nd; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: George.VanBuren@bcm.edu., Camp ER; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza MS390, Houston, TX, 77030, USA; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, 7200 Cambridge St 7th Floor Houston, TX, 77030, USA. Electronic address: ramsay.camp@bcm.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2022 Jul; Vol. 224 (1 Pt B), pp. 635-640. Date of Electronic Publication: 2022 Mar 01.
DOI: 10.1016/j.amjsurg.2022.02.058
Abstrakt: Background: Return to Intended Oncologic Treatment (RIOT) has been proposed as a quality metric in the care of cancer patients. We sought to define factors associated with inability to RIOT in Pancreatic Ductal Adenocarcinoma (PDAC) patients.
Methods: The NCDB was queried for patients who underwent pancreaticoduodenectomy for pathologic stage IB, IIA, or IIB PDAC from 2010 to 2016. Multivariable binary logistic regression models identified factors associated with failure to RIOT, and Kaplan-Meier survival analysis and Cox multivariable regression models demonstrated the impact of failure to RIOT on survival.
Results: Increasing age (p < .001), Hispanic race (p = .002), pathological stage IB (p = .004) and IIA (p = .001) as compared to IIB, increasing hospital stay (p < .001), and open surgical approach (p = .024) were associated with increased risk of inability to RIOT. Male sex (p < .001), Charlson-Deyo scores of 0 (p < .001) and 1 (p = .001) as compared to >2, negative surgical margins (p = .048), receiving care at academic institutions (p = .001), and increasing institutional case volume (p = .001) were associated with improved odds of RIOT.
Conclusions: Patient features can impact RIOT and should be considered when designing multi-modality treatment strategies.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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