A pancreatic cancer multidisciplinary clinic: insights and outcomes
Autor: | Jennifer Steve, Sharon Winters, Amer H. Zureikat, Cindy Valko, Shira Abberbock, Melissa E. Hogg, Herbert J. Zeh, Suzanne Schiffman |
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Rok vydání: | 2015 |
Předmět: |
Oncology
Adult Male medicine.medical_specialty medicine.medical_treatment Multimodality Therapy Cancer Care Facilities 03 medical and health sciences 0302 clinical medicine Internal medicine Pancreatic cancer medicine Humans 030212 general & internal medicine Registries Survival analysis Neoadjuvant therapy Aged Neoplasm Staging Retrospective Studies Not evaluated Aged 80 and over Clinical Trials as Topic business.industry Retrospective cohort study Middle Aged Pennsylvania medicine.disease Prognosis Combined Modality Therapy Quality Improvement Survival Analysis Surgery Cancer registry Clinical trial Pancreatic Neoplasms Outcome and Process Assessment Health Care 030220 oncology & carcinogenesis Female Interdisciplinary Communication business Carcinoma Pancreatic Ductal Follow-Up Studies |
Zdroj: | The Journal of surgical research. 202(2) |
ISSN: | 1095-8673 |
Popis: | The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival.Pancreatic ductal adenocarcinoma cancer registry patients from 2008-2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC).A total of 1408 patients were identified, 557 (40%) MDC and 851 (60%) non-MDC. MDC were more likely to be an earlier stage than non-MDC (P = 0.0005): I - 4% versus 4%, II - 54% versus 43%, III - 11% versus 9%, and IV - 32% versus 44%. MDC were younger than non-MDC (68 versus 70; P = 0.005); however, younger (75) and older (≥75) patients were more likely to receive treatment in MDC than non-MDC. MDC were more likely to participate in trials than non-MDC (28% versus 14%; P 0.0001). MDC were more likely to receive treatment than non-MDC (90% versus 71%; P 0.0001). MDC were more likely to receive two (38% versus 24%; P 0.0001) or three (12% versus 9%; P = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95% confidence interval [95% CI] 0.61-1.05; P = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95% CI 0.45-1.04; P = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95% CI, 0.62-1.07; P = 0.13).Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial. |
Databáze: | OpenAIRE |
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