دورية أكاديمية
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Treatment Patterns and Outcomes in Pancreatic Cancer: A Comparative Analysis of Ontario and the USA.

التفاصيل البيبلوغرافية
العنوان: Treatment Patterns and Outcomes in Pancreatic Cancer: A Comparative Analysis of Ontario and the USA.
المؤلفون: Saadat LV; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA., Schofield E; Department of Psychiatry and Behavioral Services, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Bai X; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Curry M; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Saskin R; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada., Lipitz-Snyderman A; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Soares KC; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Kingham TP; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Jarnagin WR; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., D'Angelica MI; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Wright FC; Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Department of Surgery, University of Toronto, Toronto, ON, Canada., Irish JC; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada., Coburn NG; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.; Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Department of Surgery, University of Toronto, Toronto, ON, Canada., Wei AC; Division of Hepatopancreatobiliary, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. weia@mskcc.org.
المصدر: Annals of surgical oncology [Ann Surg Oncol] 2024 Jan; Vol. 31 (1), pp. 58-65. Date of Electronic Publication: 2023 Oct 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2005- : New York, NY : Springer
Original Publication: New York, NY : Raven Press, c1994-
مواضيع طبية MeSH: National Health Programs* , Pancreatic Neoplasms*/drug therapy, Humans ; Female ; Aged ; Ontario/epidemiology ; Combined Modality Therapy ; Registries ; Neoadjuvant Therapy ; Retrospective Studies
مستخلص: Background: Comparative studies evaluating quality of care in different healthcare systems can guide reform initiatives. This study seeks to characterize best practices by comparing utilization and outcomes for patients with pancreatic cancer (PC) in the USA and Ontario, Canada.
Methods: Patients (age ≥ 66 years) with PC were identified from the Ontario Cancer Registry and SEER-Medicare databases from 2006 to 2015. Demographics and treatment (surgery, radiation, chemotherapy, or multimodality (surgery and chemotherapy)) were described. In resected patients, neoadjuvant therapy, readmission, and 30- and 90-day postoperative mortality rates were calculated. Survival was assessed using Kaplan-Meier curves.
Results: This study includes 38,858 and 11,512 patients with PC from the USA and Ontario, respectively. More female patients were identified in the USA (54.0%) versus Ontario (46.9%). In the entire cohort, US patients received more radiation in addition to other therapies (18.8% vs. 13.5% Ontario) and chemotherapy alone (34.3% vs. 19.0% Ontario). While rates of resection were similar (13.4% USA vs.12.5% Ontario), multimodality therapy was more common in the UAS (9.0% vs. 6.4%). Among resected patients, neoadjuvant chemotherapy was uncommon in both groups, although more frequent in the USA (12.0% vs. 3.2% Ontario). The 30- and 90-day postoperative mortality rates were lower in Ontario vs. the USA (30-day: 3.26% vs. 4.91%; 90-day: 7.08% vs. 10.96%), however, overall survival was similar between the USA and Ontario.
Conclusions: We observed substantive differences in treatment and outcomes between PC patients in the USA and Ontario, which may reflect known differences in healthcare systems. Close evaluation of healthcare policies can inform initiatives to improve care quality.
(© 2023. Society of Surgical Oncology.)
التعليقات: Comment in: Ann Surg Oncol. 2024 Mar;31(3):1937-1938. (PMID: 37865939)
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معلومات مُعتمدة: P30-CA008748 National Cancer Institute Cancer Center Core Grant
تواريخ الأحداث: Date Created: 20231013 Date Completed: 20231207 Latest Revision: 20240312
رمز التحديث: 20240313
DOI: 10.1245/s10434-023-14375-6
PMID: 37833463
قاعدة البيانات: MEDLINE
الوصف
تدمد:1534-4681
DOI:10.1245/s10434-023-14375-6