Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database
| Autor: | Mustapha Adham, Olivier Berthelet, Isabelle Ray-Coquard, Pierre-Jean Ternamian, Charles Mastier, Bruno Aublet-Cuvellier, Thomas Walter, Yohan Fayet, Christine Rebischung, Bruno Ferroud-Plattet, M. Baconnier, Nicolas Williet, Hélène Labrosse, Christelle De La Fouchardiere, Anne-Marie Marion-Audibert, Pascal Artru, Fadila Farsi, Claude Darcha, Antoine Duclos, Emmanuel Buc, Andrée-Laure Herr, Georges Chambon, Valérie Hervieu |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Pancreatic ductal adenocarcinoma medicine.medical_treatment Population pancreatic cancer 030230 surgery computer.software_genre survival Article 03 medical and health sciences 0302 clinical medicine real-life data Pancreatic cancer medicine pancreatic surgery education Survival rate RC254-282 disparities access to care education.field_of_study adenocarcinoma Database business.industry Incidence (epidemiology) Public health Neoplasms. Tumors. Oncology. Including cancer and carcinogens PDAC medicine.disease Radiation therapy Oncology 030220 oncology & carcinogenesis medical pathway Adenocarcinoma expertise business computer |
| Zdroj: | Cancers Volume 13 Issue 14 Cancers, Vol 13, Iss 3515, p 3515 (2021) |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers13143515 |
| Popis: | Simple Summary With an increasing incidence, late diagnosis, and high mortality rate, pancreatic adenocarcinoma remains, in 2021, a real challenge for health institutions and professionals worldwide. Despite significant therapeutic progress, the five-year survival after diagnosis remains poor. Furthermore, disparities in the access to care (often participating in late diagnosis) have been described in demographic, clinical, and/or socioeconomic factors. We decided to assess in our region, over 1 year (2016), the real-life pancreatic cancer’s management by the analysis of French hospital discharge summaries database system. We pointed out, in a large patient population (n = 1872), the inverse correlation between the level of expertise of the health facility in which the patient had his first hospital stay and the likelihood of undergoing any specific treatment for PDAC. A deeper analysis of the medical pathway for pancreatic adenocarcinomas patients is ongoing in order to suggest adapted public health measures. Abstract Pancreatic ductal adenocarcinoma (PDAC) remains a major public health challenge, and faces disparities and delays in the diagnosis and access to care. Our purposes were to describe the medical path of PDAC patients in the real-life setting and evaluate the overall survival at 1 year. We used the national hospital discharge summaries database system to analyze the management of patients with newly diagnosed PDAC over the year 2016 in Auvergne-Rhône-Alpes region (AuRA) (France). A total of 1872 patients met inclusion criteria corresponding to an incidence of 22.6 per 100,000 person-year. Within the follow-up period, 353 (18.9%) were operated with a curative intent, 743 (39.7%) underwent chemo- and/or radiotherapy, and 776 (41.4%) did not receive any of these treatments. Less than half of patients were operated in a high-volume center, defined by more than 20 PDAC resections performed annually, mainly university hospitals. The 1-year survival rate was 47% in the overall population. This study highlights that a significant number of patients with PDAC are still operated in low-volume centers or do not receive any specific oncological treatment. A detailed analysis of the medical pathways is necessary in order to identify the medical and territorial determinants and their impact on the patient’s outcome. |
| Databáze: | OpenAIRE |
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