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    Progress for resectable pancreatic [corrected] cancer?: a population-based assessment of US practices

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    Authors
    Simons, Jessica P.
    Ng, Sing Chau
    McDade, Theodore P.
    Zhou, Zheng
    Earle, Craig C.
    Tseng, Jennifer F.
    UMass Chan Affiliations
    Department of Surgery
    Document Type
    Journal Article
    Publication Date
    2010-02-10
    Keywords
    Aged
    Aged, 80 and over
    Chemotherapy, Adjuvant
    Combined Modality Therapy
    Comorbidity
    Female
    Humans
    Male
    Neoadjuvant Therapy
    Pancreatic Neoplasms
    Population Surveillance
    Radiotherapy, Adjuvant
    SEER Program
    United States
    Surgery
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    Link to Full Text
    http://dx.doi.org/10.1002/cncr.24918
    Abstract
    BACKGROUND: : Pancreatic adenocarcinoma is a deadly disease; however, recent studies have suggested improved outcomes in patients with locoregional cancer. Progress was evaluated at a national level in resected patients, as measured by the proportion who received guideline-directed treatment and trends in survival. METHODS: : The linked Surveillance, Epidemiology, and End Results and Medicare databases were queried to identify resections for pancreatic adenocarcinoma performed between 1991 and 2002. Receipt and timing of chemotherapy and radiation with respect to time-trend were assessed. Using logistic regression, factors associated with adjuvant combination chemoradiotherapy were identified. Kaplan-Meier curves stratified by year and treatment were used to assess survival. RESULTS: : Of the 1910 patients, 47.9% (n = 915) received some form of adjuvant therapy within the first 6 months postoperatively; 34.4% (n = 658) received combination chemoradiotherapy (chemoRT). ChemoRT demonstrated a significant increase, from 29.2% to 37.5% (P < .0001). Neoadjuvant therapy was used in 5.7% (n = 108) of patients; no trend was observed during the study (P = .1275). The in-hospital mortality rate was 8.0% (n = 153 patients); no significant trend was noted (P = .3116). Kaplan-Meier survival, stratified by year group of diagnosis, did not change significantly over time (log-rank test, P = .4381), even with comparisons of the first 3 years with the last 3 years of the study (log-rank test, P = .3579). CONCLUSIONS: : Adherence to guideline-directed care isimproving in the United States; however, the pace is slow, and overall survival has yet to be impacted significantly. Both increased use of adjuvant therapy and the development of more promising systemic treatments are necessary to improve survival for patients with resectable pancreatic cancer. Cancer 2010. (c) 2010 American Cancer Society.
    Source
    Cancer. 2010 Apr 1;116(7):1681-90. Link to article on publisher's site
    DOI
    10.1002/cncr.24918
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49817
    PubMed ID
    20143432
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/cncr.24918
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