Structural and Socio-Spatial Determinants Influencing Care and Survival of Patients with a Pancreatic Adenocarcinoma: Results of the PANDAURA Cohort

Autor:	Gaël S. Roth, Yohan Fayet, Sakina Benmameche-Medjahed, Françoise Ducimetière, Amandine Charreton, Claire Cropet, Sylvie Chabaud, Anne-Marie Marion-Audibert, Olivier Berthelet, Thomas Walter, Mustapha Adham, Mathieu Baconnier, David Tavan, Nicolas Williet, Pascal Artru, Floriane Huet-Penz, Isabelle Ray-Coquard, Fadila Farsi, Hélène Labrosse, Christelle de la Fouchardière
Rok vydání:	2022
Předmět:	Cancer Research Oncology pancreatic adenocarcinoma socio-spatial disparities care delays general practitioner localized potential accessibility pancreatic surgery
Zdroj:	Cancers; Volume 14; Issue 21; Pages: 5413
ISSN:	2072-6694
Popis:	Background and aims: Pancreatic cancer is highly lethal and often diagnosed at an advanced stage. This cohort study analyzes the impact of care pathways, delays, and socio-spatial determinants on pancreatic cancer patients’ diagnosis, treatment, and prognosis. Method: Patients with pancreatic adenocarcinoma newly diagnosed at all stages between January and June 2016 in the AuRA French region were included. The influence on survival of delays of care, healthcare centers’ expertise, and socio-spatial determinants was evaluated. Results: Here, 538 patients were included in 76 centers including 116 patients (21.8%) with resectable, 64 (12.0%) borderline-resectable, 147 (27.6%) locally-advanced tumors, and 205 (38.5%) with metastatic disease. A delay between first symptoms and CT scans did not statistically influence overall survival (OS). In resected patients, OS was significantly higher in centers with more than 20 surgeries (HR 20 surgeries/year p = 0.0081). Regarding socio-spatial determinants, patients living in municipalities with greater access to a general practitioner (HR = 1.673, p = 0.0153) or with a population density below 795.1 people/km2 (HR = 1.881, p = 0.0057) were significantly more often resectable. Conclusion: This cohort study supports the pivotal role of general practitioner in cancer care and the importance of the centralization of pancreatic surgery to optimize pancreatic cancer patients’ care and outcomes. However, delays of care did not impact patient survival.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5ff4fbb437b3e04c523074a6f7e8ecb4 https://pubmed.ncbi.nlm.nih.gov/36358831 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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