Hepatopancreatobiliary malignancies: time to treatment matters
Initiation of oncologic care is often delayed, yet little is known about delays in hepatopancreatobiliary (HPB) cancers or their impact. This retrospective cohort study describes trends in time to treatment initiation (TTI), assesses the association between TTI and survival, and identifies predictor...
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| Veröffentlicht in: | Journal of gastrointestinal oncology 2023-04, Vol.14 (2), p.833-848 |
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| container_title | Journal of gastrointestinal oncology |
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| creator | Kerekes, Daniel M Frey, Alexander E Bakkila, Baylee F Johnson, Caroline H Becher, Robert D Billingsley, Kevin G Khan, Sajid A |
| description | Initiation of oncologic care is often delayed, yet little is known about delays in hepatopancreatobiliary (HPB) cancers or their impact. This retrospective cohort study describes trends in time to treatment initiation (TTI), assesses the association between TTI and survival, and identifies predictors of TTI in HPB cancers.
The National Cancer Database was queried for patients with cancers of the pancreas, liver, and bile ducts between 2004 and 2017. Kaplan-Meier survival analysis and Cox regression were used to investigate the association between TTI and overall survival for each cancer type and stage. Multivariable regression identified factors associated with longer TTI.
Of 318,931 patients with HPB cancers, median TTI was 31 days. Longer TTI was associated with increased mortality in patients with stages I-III extrahepatic bile duct (EHBD) cancer and stages I-II pancreatic adenocarcinoma. Patients treated within 3-30, 31-60, and 61-90 days had median survivals of 51.5, 34.9, and 25.4 months (log-rank P |
| doi_str_mv | 10.21037/jgo-22-1067 |
| format | Article |
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The National Cancer Database was queried for patients with cancers of the pancreas, liver, and bile ducts between 2004 and 2017. Kaplan-Meier survival analysis and Cox regression were used to investigate the association between TTI and overall survival for each cancer type and stage. Multivariable regression identified factors associated with longer TTI.
Of 318,931 patients with HPB cancers, median TTI was 31 days. Longer TTI was associated with increased mortality in patients with stages I-III extrahepatic bile duct (EHBD) cancer and stages I-II pancreatic adenocarcinoma. Patients treated within 3-30, 31-60, and 61-90 days had median survivals of 51.5, 34.9, and 25.4 months (log-rank P<0.001), respectively, for stage I EHBD cancer, and 18.8, 16.6, and 15.2 months for stage I pancreatic cancer, respectively (P<0.001). Factors associated with increased TTI included stage I disease (+13.7 days
stage IV, P<0.001), treatment with radiation only (β=+13.9 days, P<0.001), Black race (+4.6 days, P<0.001) and Hispanic ethnicity (+4.3 days, P<0.001).
Some HPB cancer patients with longer time to definitive care experienced higher mortality than patients treated expeditiously, particularly in non-metastatic EHBD cancer. Black and Hispanic patients are at risk for delayed treatment. Further research into these associations is needed.]]></description><identifier>ISSN: 2078-6891</identifier><identifier>EISSN: 2219-679X</identifier><identifier>DOI: 10.21037/jgo-22-1067</identifier><identifier>PMID: 37201090</identifier><language>eng</language><publisher>China: AME Publishing Company</publisher><subject>Original</subject><ispartof>Journal of gastrointestinal oncology, 2023-04, Vol.14 (2), p.833-848</ispartof><rights>2023 Journal of Gastrointestinal Oncology. All rights reserved.</rights><rights>2023 Journal of Gastrointestinal Oncology. All rights reserved. 2023 Journal of Gastrointestinal Oncology.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c385t-3466a6bbb9a160ac97b4d4bf1cf20684edf734cbfb54da40beaf330286c7b2143</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186552/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186552/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37201090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kerekes, Daniel M</creatorcontrib><creatorcontrib>Frey, Alexander E</creatorcontrib><creatorcontrib>Bakkila, Baylee F</creatorcontrib><creatorcontrib>Johnson, Caroline H</creatorcontrib><creatorcontrib>Becher, Robert D</creatorcontrib><creatorcontrib>Billingsley, Kevin G</creatorcontrib><creatorcontrib>Khan, Sajid A</creatorcontrib><title>Hepatopancreatobiliary malignancies: time to treatment matters</title><title>Journal of gastrointestinal oncology</title><addtitle>J Gastrointest Oncol</addtitle><description><![CDATA[Initiation of oncologic care is often delayed, yet little is known about delays in hepatopancreatobiliary (HPB) cancers or their impact. This retrospective cohort study describes trends in time to treatment initiation (TTI), assesses the association between TTI and survival, and identifies predictors of TTI in HPB cancers.
The National Cancer Database was queried for patients with cancers of the pancreas, liver, and bile ducts between 2004 and 2017. Kaplan-Meier survival analysis and Cox regression were used to investigate the association between TTI and overall survival for each cancer type and stage. Multivariable regression identified factors associated with longer TTI.
Of 318,931 patients with HPB cancers, median TTI was 31 days. Longer TTI was associated with increased mortality in patients with stages I-III extrahepatic bile duct (EHBD) cancer and stages I-II pancreatic adenocarcinoma. Patients treated within 3-30, 31-60, and 61-90 days had median survivals of 51.5, 34.9, and 25.4 months (log-rank P<0.001), respectively, for stage I EHBD cancer, and 18.8, 16.6, and 15.2 months for stage I pancreatic cancer, respectively (P<0.001). Factors associated with increased TTI included stage I disease (+13.7 days
stage IV, P<0.001), treatment with radiation only (β=+13.9 days, P<0.001), Black race (+4.6 days, P<0.001) and Hispanic ethnicity (+4.3 days, P<0.001).
Some HPB cancer patients with longer time to definitive care experienced higher mortality than patients treated expeditiously, particularly in non-metastatic EHBD cancer. Black and Hispanic patients are at risk for delayed treatment. Further research into these associations is needed.]]></description><subject>Original</subject><issn>2078-6891</issn><issn>2219-679X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpVkM1LAzEQxYMottTePMsePbiar002HhQpaoWCFwVvIclma8p-maSC_72prUXnMsPMjzePB8ApgpcYQcKvVss-xzhHkPEDMMYYiZxx8XaYZsjLnJUCjcA0hBVMRUUBC3wMRoRjiKCAY3Azt4OK_aA6420atGuc8l9Zqxq37NLW2XCdRdfaLPZZ3DCt7WK6x2h9OAFHtWqCne76BLw-3L_M5vni-fFpdrfIDSmLmBPKmGJaa6EQg8oIrmlFdY1MjSErqa1qTqjRtS5opSjUVtWEQFwywzVGlEzA7VZ3WOvWViZZ8KqRg3dtcit75eT_S-fe5bL_lAiikhUFTgrnOwXff6xtiLJ1wdimUZ3t10HiEjHOkGAkoRdb1Pg-BG_r_R8E5U_sMsUuMZab2BN-9tfbHv4NmXwDW_N_3A</recordid><startdate>20230429</startdate><enddate>20230429</enddate><creator>Kerekes, Daniel M</creator><creator>Frey, Alexander E</creator><creator>Bakkila, Baylee F</creator><creator>Johnson, Caroline H</creator><creator>Becher, Robert D</creator><creator>Billingsley, Kevin G</creator><creator>Khan, Sajid A</creator><general>AME Publishing Company</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230429</creationdate><title>Hepatopancreatobiliary malignancies: time to treatment matters</title><author>Kerekes, Daniel M ; Frey, Alexander E ; Bakkila, Baylee F ; Johnson, Caroline H ; Becher, Robert D ; Billingsley, Kevin G ; Khan, Sajid A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c385t-3466a6bbb9a160ac97b4d4bf1cf20684edf734cbfb54da40beaf330286c7b2143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Original</topic><toplevel>online_resources</toplevel><creatorcontrib>Kerekes, Daniel M</creatorcontrib><creatorcontrib>Frey, Alexander E</creatorcontrib><creatorcontrib>Bakkila, Baylee F</creatorcontrib><creatorcontrib>Johnson, Caroline H</creatorcontrib><creatorcontrib>Becher, Robert D</creatorcontrib><creatorcontrib>Billingsley, Kevin G</creatorcontrib><creatorcontrib>Khan, Sajid A</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastrointestinal oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kerekes, Daniel M</au><au>Frey, Alexander E</au><au>Bakkila, Baylee F</au><au>Johnson, Caroline H</au><au>Becher, Robert D</au><au>Billingsley, Kevin G</au><au>Khan, Sajid A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatopancreatobiliary malignancies: time to treatment matters</atitle><jtitle>Journal of gastrointestinal oncology</jtitle><addtitle>J Gastrointest Oncol</addtitle><date>2023-04-29</date><risdate>2023</risdate><volume>14</volume><issue>2</issue><spage>833</spage><epage>848</epage><pages>833-848</pages><issn>2078-6891</issn><eissn>2219-679X</eissn><abstract><![CDATA[Initiation of oncologic care is often delayed, yet little is known about delays in hepatopancreatobiliary (HPB) cancers or their impact. This retrospective cohort study describes trends in time to treatment initiation (TTI), assesses the association between TTI and survival, and identifies predictors of TTI in HPB cancers.
The National Cancer Database was queried for patients with cancers of the pancreas, liver, and bile ducts between 2004 and 2017. Kaplan-Meier survival analysis and Cox regression were used to investigate the association between TTI and overall survival for each cancer type and stage. Multivariable regression identified factors associated with longer TTI.
Of 318,931 patients with HPB cancers, median TTI was 31 days. Longer TTI was associated with increased mortality in patients with stages I-III extrahepatic bile duct (EHBD) cancer and stages I-II pancreatic adenocarcinoma. Patients treated within 3-30, 31-60, and 61-90 days had median survivals of 51.5, 34.9, and 25.4 months (log-rank P<0.001), respectively, for stage I EHBD cancer, and 18.8, 16.6, and 15.2 months for stage I pancreatic cancer, respectively (P<0.001). Factors associated with increased TTI included stage I disease (+13.7 days
stage IV, P<0.001), treatment with radiation only (β=+13.9 days, P<0.001), Black race (+4.6 days, P<0.001) and Hispanic ethnicity (+4.3 days, P<0.001).
Some HPB cancer patients with longer time to definitive care experienced higher mortality than patients treated expeditiously, particularly in non-metastatic EHBD cancer. Black and Hispanic patients are at risk for delayed treatment. Further research into these associations is needed.]]></abstract><cop>China</cop><pub>AME Publishing Company</pub><pmid>37201090</pmid><doi>10.21037/jgo-22-1067</doi><tpages>16</tpages><oa>free_for_read</oa></addata></record> |
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| title | Hepatopancreatobiliary malignancies: time to treatment matters |
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