دورية أكاديمية
Pancreatic Cancer Multidisciplinary Clinic is Associated with Improved Treatment and Elimination of Socioeconomic Disparities.
| العنوان: | Pancreatic Cancer Multidisciplinary Clinic is Associated with Improved Treatment and Elimination of Socioeconomic Disparities. |
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| المؤلفون: | Hoehn RS; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Richard.Hoehn@UHhospitals.org.; Division of Surgical Oncology, University Hospitals, Cleveland, OH, USA. Richard.Hoehn@UHhospitals.org., Zenati M; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Rieser CJ; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Stitt L; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Winters S; Cancer Registries, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Paniccia A; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Zureikat AH; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Mar; Vol. 31 (3), pp. 1906-1915. Date of Electronic Publication: 2023 Nov 21. |
| 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: | Socioeconomic Disparities in Health* , Pancreatic Neoplasms*/therapy, Humans ; Retrospective Studies ; Survival Analysis ; Combined Modality Therapy |
| مستخلص: | Objective: To identify the association between multidisciplinary clinic (MDC) management and disparities in treatment for patients with pancreatic cancer. Background: Socioeconomic status (SES) predicts treatment and survival for pancreatic cancer. Multidisciplinary clinics (MDCs) may improve surgical management for these patients. Methods: This is a retrospective cohort study (2010-2018) of all pancreatic cancer patients within a large, regional hospital system with a high-volume pancreatic cancer MDC. The primary outcome was receipt of treatment (surgery, chemotherapy, radiation, clinical trial participation, and palliative care); the secondary outcomes were overall survival and MDC management. Multiple logistic regressions were used for binary outcomes. Survival was analyzed using Kaplan-Meier survival analysis, Cox proportional hazards, and inverse probability of treatment weighting (IPTW). Results: Of the 4141 patients studied, 1420 (34.3%) were managed by the MDC. MDC management was more likely for patients who were younger age, married, and privately insured, while less likely for low SES patients (all p < 0.05). MDC patients were more likely to receive all treatments, including neoadjuvant chemotherapy (OR 3.33, 95% CI 2.82-3.93), surgery (OR 1.39, 95% CI 1.15-1.68), palliative care (OR 1.21, 95% CI 1.05-1.38), and clinical trial participation (OR 3.76, 95% CI 2.86-4.93). Low SES patients were less likely to undergo surgery outside of the MDC (OR 0.47, 95% CI 0.31-0.73) but there was no difference within the MDC (OR 1.10, 95% CI 0.68-1.77). Across multiple survival analyses, low SES predicted inferior survival outside of the MDC, but there was no association among MDC patients. Conclusion: Multidisciplinary team-based care increases rates of treatment and eliminates socioeconomic disparities for pancreatic cancer patients. (© 2023. Society of Surgical Oncology.) |
| التعليقات: | Comment in: Ann Surg Oncol. 2024 Mar;31(3):1941-1942. (PMID: 38082163) |
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| معلومات مُعتمدة: | institutional pilot award Shadyside Hospital Foundation |
| فهرسة مساهمة: | Keywords: Cancer disparities; Pancreatic cancer; Socioeconomic status |
| تواريخ الأحداث: | Date Created: 20231122 Date Completed: 20240208 Latest Revision: 20240312 |
| رمز التحديث: | 20240313 |
| DOI: | 10.1245/s10434-023-14609-7 |
| PMID: | 37989957 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1534-4681 |
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| DOI: | 10.1245/s10434-023-14609-7 |