Population‐based analysis of treatment patterns and outcomes for pancreas cancer in Victoria
Background The Victorian Pancreas Cancer summit 2017 analysed state‐wide data on management of Victorians with pancreas cancer between 2011 and 2015 to identify variations in care and outcomes. Pancreas cancer remains a formidable disease but systemic therapies are increasingly effective. Surgery re...
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Veröffentlicht in: | ANZ journal of surgery 2020-09, Vol.90 (9), p.1677-1682 |
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creator | Pilgrim, Charles H. C. te Marvelde, Luc Stuart, Ella Croagh, Dan Deutscher, David Nikfarjam, Mehrdad Lee, Belinda Christophi, Christopher |
description | Background
The Victorian Pancreas Cancer summit 2017 analysed state‐wide data on management of Victorians with pancreas cancer between 2011 and 2015 to identify variations in care and outcomes. Pancreas cancer remains a formidable disease but systemic therapies are increasingly effective. Surgery remains essential but insufficient alone for cure. Understanding patterns of care and identifying variations in treatment is critical to improving outcomes.
Methods
This population‐based study analysed data collected prospectively by Department of Health and Human services (Victorian state government). Data were extracted from Victorian Cancer Registry (covering all Victorian cancer diagnoses), Victorian Admitted‐Episodes Dataset (all inpatient data), Victorian Radiotherapy Minimum Dataset and Victorian Death Index providing demographics, tumour and treatment characteristics, age‐standardized incidence, overall and median survival.
Results
Of 3962 Victorian patients with any form of pancreatic malignancy, 82% were ductal adenocarcinoma (PDAC), of whom 67% had metastases at diagnosis. One‐year overall survival for PDAC was 30% (60% non‐metastatic, 15% if metastatic). Median survival with metastases increased from 2.7 to 3.9 months, and from 13.3 to 15.9 months for non‐metastatic PDAC between 2011 and 2015. Thirty‐one percent of non‐metastatic patients underwent pancreatectomy. About 1.5% were treated with neoadjuvant chemotherapy/chemoradiation. Of patients undergoing intended curative resection, 77% proceeded to adjuvant therapy. Fifty‐one percent of metastatic PDAC patients never received anti‐tumour therapy.
Conclusions
Nearly one‐fourth of surgically treated patients never received systemic therapy. More than two‐thirds of non‐metastatic patients never proceeded to surgery. Further consideration of neoadjuvant therapy should be given to borderline resectable patients. Most patients with PDAC still die soon after diagnosis, but median survival is increasing.
All patients in Victoria with pancreas cancer diagnosed between 2011 and 2015 were included in this population study. Of most note, 23% of patients treated with intended curative intent never received systemic therapy. Only 1.5% were treated with neoadjuvant therapy and 51% with metastatic disease never received any anti‐tumour treatment. |
doi_str_mv | 10.1111/ans.15721 |
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The Victorian Pancreas Cancer summit 2017 analysed state‐wide data on management of Victorians with pancreas cancer between 2011 and 2015 to identify variations in care and outcomes. Pancreas cancer remains a formidable disease but systemic therapies are increasingly effective. Surgery remains essential but insufficient alone for cure. Understanding patterns of care and identifying variations in treatment is critical to improving outcomes.
Methods
This population‐based study analysed data collected prospectively by Department of Health and Human services (Victorian state government). Data were extracted from Victorian Cancer Registry (covering all Victorian cancer diagnoses), Victorian Admitted‐Episodes Dataset (all inpatient data), Victorian Radiotherapy Minimum Dataset and Victorian Death Index providing demographics, tumour and treatment characteristics, age‐standardized incidence, overall and median survival.
Results
Of 3962 Victorian patients with any form of pancreatic malignancy, 82% were ductal adenocarcinoma (PDAC), of whom 67% had metastases at diagnosis. One‐year overall survival for PDAC was 30% (60% non‐metastatic, 15% if metastatic). Median survival with metastases increased from 2.7 to 3.9 months, and from 13.3 to 15.9 months for non‐metastatic PDAC between 2011 and 2015. Thirty‐one percent of non‐metastatic patients underwent pancreatectomy. About 1.5% were treated with neoadjuvant chemotherapy/chemoradiation. Of patients undergoing intended curative resection, 77% proceeded to adjuvant therapy. Fifty‐one percent of metastatic PDAC patients never received anti‐tumour therapy.
Conclusions
Nearly one‐fourth of surgically treated patients never received systemic therapy. More than two‐thirds of non‐metastatic patients never proceeded to surgery. Further consideration of neoadjuvant therapy should be given to borderline resectable patients. Most patients with PDAC still die soon after diagnosis, but median survival is increasing.
All patients in Victoria with pancreas cancer diagnosed between 2011 and 2015 were included in this population study. Of most note, 23% of patients treated with intended curative intent never received systemic therapy. Only 1.5% were treated with neoadjuvant therapy and 51% with metastatic disease never received any anti‐tumour treatment.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.15721</identifier><identifier>PMID: 32347639</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Adenocarcinoma ; Antineoplastic Combined Chemotherapy Protocols ; Cancer ; Cancer therapies ; Carcinoma, Pancreatic Ductal - surgery ; Chemoradiotherapy ; Chemotherapy ; Combined Modality Therapy ; Data analysis ; Datasets ; Demographics ; Demography ; Diagnosis ; Federal agencies ; hepatopancreaticobiliary surgery ; Humans ; Malignancy ; Metastases ; Metastasis ; Neoadjuvant Therapy ; Pancreas ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms - epidemiology ; Pancreatic Neoplasms - therapy ; Patients ; Population studies ; Radiation therapy ; Surgery ; surgical oncology ; Survival ; Tumors</subject><ispartof>ANZ journal of surgery, 2020-09, Vol.90 (9), p.1677-1682</ispartof><rights>2020 Royal Australasian College of Surgeons</rights><rights>2020 Royal Australasian College of Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-a0baf5f50aa5b95c9282db905b2509f5a561958ac3b09fcdc43c14a6b19917983</citedby><cites>FETCH-LOGICAL-c3881-a0baf5f50aa5b95c9282db905b2509f5a561958ac3b09fcdc43c14a6b19917983</cites><orcidid>0000-0003-2193-7305</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.15721$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.15721$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32347639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pilgrim, Charles H. C.</creatorcontrib><creatorcontrib>te Marvelde, Luc</creatorcontrib><creatorcontrib>Stuart, Ella</creatorcontrib><creatorcontrib>Croagh, Dan</creatorcontrib><creatorcontrib>Deutscher, David</creatorcontrib><creatorcontrib>Nikfarjam, Mehrdad</creatorcontrib><creatorcontrib>Lee, Belinda</creatorcontrib><creatorcontrib>Christophi, Christopher</creatorcontrib><title>Population‐based analysis of treatment patterns and outcomes for pancreas cancer in Victoria</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
The Victorian Pancreas Cancer summit 2017 analysed state‐wide data on management of Victorians with pancreas cancer between 2011 and 2015 to identify variations in care and outcomes. Pancreas cancer remains a formidable disease but systemic therapies are increasingly effective. Surgery remains essential but insufficient alone for cure. Understanding patterns of care and identifying variations in treatment is critical to improving outcomes.
Methods
This population‐based study analysed data collected prospectively by Department of Health and Human services (Victorian state government). Data were extracted from Victorian Cancer Registry (covering all Victorian cancer diagnoses), Victorian Admitted‐Episodes Dataset (all inpatient data), Victorian Radiotherapy Minimum Dataset and Victorian Death Index providing demographics, tumour and treatment characteristics, age‐standardized incidence, overall and median survival.
Results
Of 3962 Victorian patients with any form of pancreatic malignancy, 82% were ductal adenocarcinoma (PDAC), of whom 67% had metastases at diagnosis. One‐year overall survival for PDAC was 30% (60% non‐metastatic, 15% if metastatic). Median survival with metastases increased from 2.7 to 3.9 months, and from 13.3 to 15.9 months for non‐metastatic PDAC between 2011 and 2015. Thirty‐one percent of non‐metastatic patients underwent pancreatectomy. About 1.5% were treated with neoadjuvant chemotherapy/chemoradiation. Of patients undergoing intended curative resection, 77% proceeded to adjuvant therapy. Fifty‐one percent of metastatic PDAC patients never received anti‐tumour therapy.
Conclusions
Nearly one‐fourth of surgically treated patients never received systemic therapy. More than two‐thirds of non‐metastatic patients never proceeded to surgery. Further consideration of neoadjuvant therapy should be given to borderline resectable patients. Most patients with PDAC still die soon after diagnosis, but median survival is increasing.
All patients in Victoria with pancreas cancer diagnosed between 2011 and 2015 were included in this population study. Of most note, 23% of patients treated with intended curative intent never received systemic therapy. Only 1.5% were treated with neoadjuvant therapy and 51% with metastatic disease never received any anti‐tumour treatment.</description><subject>Adenocarcinoma</subject><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Data analysis</subject><subject>Datasets</subject><subject>Demographics</subject><subject>Demography</subject><subject>Diagnosis</subject><subject>Federal agencies</subject><subject>hepatopancreaticobiliary surgery</subject><subject>Humans</subject><subject>Malignancy</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Neoadjuvant Therapy</subject><subject>Pancreas</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Patients</subject><subject>Population studies</subject><subject>Radiation therapy</subject><subject>Surgery</subject><subject>surgical oncology</subject><subject>Survival</subject><subject>Tumors</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MtKxDAUBuAgijNeFr6ABNzoojO5NG2zHAZvMKjgZWk5TVPo0DZjkiKz8xF8Rp_EaEcXgtnkhPPxQ36EjiiZ0HCm0LkJFSmjW2hM41hEjMp0ezPTmPMR2nNuSQhNEil20YgzHqcJl2P0fGdWfQO-Nt3H23sBTpcYOmjWrnbYVNhbDb7Vnccr8F7bzoV1iU3vlWm1w5WxYdOpwBxWYdAW1x1-qpU3toYDtFNB4_Th5t5HjxfnD_OraHF7eT2fLSLFs4xGQAqoRCUIgCikUJJlrCwkEQUTRFYCREKlyEDxIjxVqWKuaAxJQaWkqcz4PjodclfWvPTa-bytndJNA502vcsZlwknPGVpoCd_6NL0Nnw5qDhmAWUZC-psUMoa56yu8pWtW7DrnJL8q_Q8lJ5_lx7s8SaxL1pd_sqflgOYDuC1bvT6_6R8dnM_RH4C1iqMYA</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Pilgrim, Charles H. C.</creator><creator>te Marvelde, Luc</creator><creator>Stuart, Ella</creator><creator>Croagh, Dan</creator><creator>Deutscher, David</creator><creator>Nikfarjam, Mehrdad</creator><creator>Lee, Belinda</creator><creator>Christophi, Christopher</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2193-7305</orcidid></search><sort><creationdate>202009</creationdate><title>Population‐based analysis of treatment patterns and outcomes for pancreas cancer in Victoria</title><author>Pilgrim, Charles H. C. ; te Marvelde, Luc ; Stuart, Ella ; Croagh, Dan ; Deutscher, David ; Nikfarjam, Mehrdad ; Lee, Belinda ; Christophi, Christopher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-a0baf5f50aa5b95c9282db905b2509f5a561958ac3b09fcdc43c14a6b19917983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma</topic><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Combined Modality Therapy</topic><topic>Data analysis</topic><topic>Datasets</topic><topic>Demographics</topic><topic>Demography</topic><topic>Diagnosis</topic><topic>Federal agencies</topic><topic>hepatopancreaticobiliary surgery</topic><topic>Humans</topic><topic>Malignancy</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Neoadjuvant Therapy</topic><topic>Pancreas</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - epidemiology</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Patients</topic><topic>Population studies</topic><topic>Radiation therapy</topic><topic>Surgery</topic><topic>surgical oncology</topic><topic>Survival</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pilgrim, Charles H. C.</creatorcontrib><creatorcontrib>te Marvelde, Luc</creatorcontrib><creatorcontrib>Stuart, Ella</creatorcontrib><creatorcontrib>Croagh, Dan</creatorcontrib><creatorcontrib>Deutscher, David</creatorcontrib><creatorcontrib>Nikfarjam, Mehrdad</creatorcontrib><creatorcontrib>Lee, Belinda</creatorcontrib><creatorcontrib>Christophi, Christopher</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pilgrim, Charles H. C.</au><au>te Marvelde, Luc</au><au>Stuart, Ella</au><au>Croagh, Dan</au><au>Deutscher, David</au><au>Nikfarjam, Mehrdad</au><au>Lee, Belinda</au><au>Christophi, Christopher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population‐based analysis of treatment patterns and outcomes for pancreas cancer in Victoria</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2020-09</date><risdate>2020</risdate><volume>90</volume><issue>9</issue><spage>1677</spage><epage>1682</epage><pages>1677-1682</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
The Victorian Pancreas Cancer summit 2017 analysed state‐wide data on management of Victorians with pancreas cancer between 2011 and 2015 to identify variations in care and outcomes. Pancreas cancer remains a formidable disease but systemic therapies are increasingly effective. Surgery remains essential but insufficient alone for cure. Understanding patterns of care and identifying variations in treatment is critical to improving outcomes.
Methods
This population‐based study analysed data collected prospectively by Department of Health and Human services (Victorian state government). Data were extracted from Victorian Cancer Registry (covering all Victorian cancer diagnoses), Victorian Admitted‐Episodes Dataset (all inpatient data), Victorian Radiotherapy Minimum Dataset and Victorian Death Index providing demographics, tumour and treatment characteristics, age‐standardized incidence, overall and median survival.
Results
Of 3962 Victorian patients with any form of pancreatic malignancy, 82% were ductal adenocarcinoma (PDAC), of whom 67% had metastases at diagnosis. One‐year overall survival for PDAC was 30% (60% non‐metastatic, 15% if metastatic). Median survival with metastases increased from 2.7 to 3.9 months, and from 13.3 to 15.9 months for non‐metastatic PDAC between 2011 and 2015. Thirty‐one percent of non‐metastatic patients underwent pancreatectomy. About 1.5% were treated with neoadjuvant chemotherapy/chemoradiation. Of patients undergoing intended curative resection, 77% proceeded to adjuvant therapy. Fifty‐one percent of metastatic PDAC patients never received anti‐tumour therapy.
Conclusions
Nearly one‐fourth of surgically treated patients never received systemic therapy. More than two‐thirds of non‐metastatic patients never proceeded to surgery. Further consideration of neoadjuvant therapy should be given to borderline resectable patients. Most patients with PDAC still die soon after diagnosis, but median survival is increasing.
All patients in Victoria with pancreas cancer diagnosed between 2011 and 2015 were included in this population study. Of most note, 23% of patients treated with intended curative intent never received systemic therapy. Only 1.5% were treated with neoadjuvant therapy and 51% with metastatic disease never received any anti‐tumour treatment.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32347639</pmid><doi>10.1111/ans.15721</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2193-7305</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adenocarcinoma Antineoplastic Combined Chemotherapy Protocols Cancer Cancer therapies Carcinoma, Pancreatic Ductal - surgery Chemoradiotherapy Chemotherapy Combined Modality Therapy Data analysis Datasets Demographics Demography Diagnosis Federal agencies hepatopancreaticobiliary surgery Humans Malignancy Metastases Metastasis Neoadjuvant Therapy Pancreas Pancreatectomy Pancreatic cancer Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - therapy Patients Population studies Radiation therapy Surgery surgical oncology Survival Tumors |
title | Population‐based analysis of treatment patterns and outcomes for pancreas cancer in Victoria |
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