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The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis

Adjuvant chemotherapy after pancreatoduodenectomy for pancreatic cancer is currently considered standard of care. In this nationwide study, we investigated which characteristics determine the likelihood of receiving adjuvant chemotherapy and its effect on overall survival. The data were obtained fro...

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Autores principales: Bakens, Maikel J., van der Geest, Lydia G., van Putten, Magreet, van Laarhoven, Hanneke W., Creemers, Geert‐Jan, Besselink, Marc G., Lemmens, Valery E., de Hingh, Ignace H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083735/
https://www.ncbi.nlm.nih.gov/pubmed/27671746
http://dx.doi.org/10.1002/cam4.921
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author Bakens, Maikel J.
van der Geest, Lydia G.
van Putten, Magreet
van Laarhoven, Hanneke W.
Creemers, Geert‐Jan
Besselink, Marc G.
Lemmens, Valery E.
de Hingh, Ignace H.
author_facet Bakens, Maikel J.
van der Geest, Lydia G.
van Putten, Magreet
van Laarhoven, Hanneke W.
Creemers, Geert‐Jan
Besselink, Marc G.
Lemmens, Valery E.
de Hingh, Ignace H.
author_sort Bakens, Maikel J.
collection PubMed
description Adjuvant chemotherapy after pancreatoduodenectomy for pancreatic cancer is currently considered standard of care. In this nationwide study, we investigated which characteristics determine the likelihood of receiving adjuvant chemotherapy and its effect on overall survival. The data were obtained from the Netherlands Cancer Registry. All patients alive 90 days after pancreatoduodenectomy for M(0)‐pancreatic cancer between 2008 and 2013 in the Netherlands were included in this study. The likelihood to receive adjuvant chemotherapy was analyzed by multilevel logistic regression analysis and differences in time‐to‐first‐chemotherapy were tested for significance by Mann–Whitney U test. Overall survival was assessed by Kaplan–Meier method and Cox regression analysis. Of the 1195 patients undergoing a pancreatoduodenectomy for pancreatic cancer, 642 (54%) patients received adjuvant chemotherapy. Proportions differed significantly between the 19 pancreatic centers, ranging from 26% to 74% (P < 0.001). Median time‐to‐first‐chemotherapy was 6.7 weeks and did not differ between centers. Patients with a higher tumor stage, younger age, and diagnosed more recently were more likely to receive adjuvant treatment. The 5‐year overall survival was significantly prolonged in patients treated with adjuvant chemotherapy—23% versus 17%, log‐rank = 0.01. In Cox regression analysis, treatment with adjuvant chemotherapy significantly prolonged survival compared with treatment without adjuvant chemotherapy. The finding that elderly patients and patients with a low tumor stage are less likely to undergo treatment needs further attention, especially since adjuvant treatment is known to prolong survival in most of these patients.
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spelling pubmed-50837352016-10-31 The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis Bakens, Maikel J. van der Geest, Lydia G. van Putten, Magreet van Laarhoven, Hanneke W. Creemers, Geert‐Jan Besselink, Marc G. Lemmens, Valery E. de Hingh, Ignace H. Cancer Med Clinical Cancer Research Adjuvant chemotherapy after pancreatoduodenectomy for pancreatic cancer is currently considered standard of care. In this nationwide study, we investigated which characteristics determine the likelihood of receiving adjuvant chemotherapy and its effect on overall survival. The data were obtained from the Netherlands Cancer Registry. All patients alive 90 days after pancreatoduodenectomy for M(0)‐pancreatic cancer between 2008 and 2013 in the Netherlands were included in this study. The likelihood to receive adjuvant chemotherapy was analyzed by multilevel logistic regression analysis and differences in time‐to‐first‐chemotherapy were tested for significance by Mann–Whitney U test. Overall survival was assessed by Kaplan–Meier method and Cox regression analysis. Of the 1195 patients undergoing a pancreatoduodenectomy for pancreatic cancer, 642 (54%) patients received adjuvant chemotherapy. Proportions differed significantly between the 19 pancreatic centers, ranging from 26% to 74% (P < 0.001). Median time‐to‐first‐chemotherapy was 6.7 weeks and did not differ between centers. Patients with a higher tumor stage, younger age, and diagnosed more recently were more likely to receive adjuvant treatment. The 5‐year overall survival was significantly prolonged in patients treated with adjuvant chemotherapy—23% versus 17%, log‐rank = 0.01. In Cox regression analysis, treatment with adjuvant chemotherapy significantly prolonged survival compared with treatment without adjuvant chemotherapy. The finding that elderly patients and patients with a low tumor stage are less likely to undergo treatment needs further attention, especially since adjuvant treatment is known to prolong survival in most of these patients. John Wiley and Sons Inc. 2016-09-27 /pmc/articles/PMC5083735/ /pubmed/27671746 http://dx.doi.org/10.1002/cam4.921 Text en © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Bakens, Maikel J.
van der Geest, Lydia G.
van Putten, Magreet
van Laarhoven, Hanneke W.
Creemers, Geert‐Jan
Besselink, Marc G.
Lemmens, Valery E.
de Hingh, Ignace H.
The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title_full The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title_fullStr The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title_full_unstemmed The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title_short The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
title_sort use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population‐based analysis
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083735/
https://www.ncbi.nlm.nih.gov/pubmed/27671746
http://dx.doi.org/10.1002/cam4.921
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