Sociodemographics and Comorbidities Influence Decisions to Undergo Pancreatic Resection for Neoplastic Lesions

Sandroussi, Charbel; Brace, Chantelle; Kennedy, Erin; Baxter, Nancy N.; Gallinger, Steven; Wei, Alice C.

doi:10.1007/s11605-010-1255-2

Cited by 13 publications

(11 citation statements)

References 54 publications

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“…That observation supports findings in the existing literature that higher scores on the Charlson comorbidity index might be associated with lower rates of surgical resection 25,26 , lessaggressive palliative chemotherapy 27 , and relatively worse outcomes with gemcitabine-based chemotherapy 28 .…”

Section: Discussionsupporting

confidence: 89%

A Population-Based Study of the Epidemiology of Pancreatic Cancer: A Brief Report

et al. 2015

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Objective Administrative data are used to describe the pancreatic cancer (pcc) population. The analysis examines demographic details, incidence, site, survival, and factors influencing mortality in a cohort of individuals diagnosed with pcc.Methods Incident cases of pcc diagnosed in Ontario between 1 January 2004 and 31 December 2011 were extracted from the Ontario Cancer Registry. They were linked by encrypted health card number to several administrative databases to obtain demographic and mortality information. Descriptive, bivariate, and survival analyses were conducted.Results During the period of interest, 9221 new cases of pcc (4548 in men, 4673 in women) were diagnosed, for an age-adjusted standardized annual incidence in the range of 8.6-9.5 per 100,000 population. Mean age at diagnosis was 70.3 ± 12.5 years (standard deviation). Five-year survival was 7.2% (12.8% for those <60 years of age and 3.6% for those >80 years of age). Survival varied by sex, older age, rural residence, lower income, site of involvement in the pancreas, and presence of comorbidity. ConclusionsThe mortality rate in pcc is exceptionally high. With an increasing incidence and a mortality positively associated with age, additional support will be needed for this highly fatal disease as demographics in Ontario continue to trend toward a higher proportion of older individuals.

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Section: Discussionsupporting

confidence: 89%

A Population-Based Study of the Epidemiology of Pancreatic Cancer: A Brief Report

et al. 2015

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“…At the individual level, disparity in outcomes have been reported for patients with pancreatic and other cancers that was related to geographic remoteness and socio‐demographic factors 15 . ‐ 17 Even when reviewed at a specialist service, the uptake of treatment by people at greater social disadvantage can be lower 15 , 18 , 19 . One‐fifth of people with resectable pancreatic cancer in NSW and Queensland were reported to have declined surgery 14 .…”

Section: Discussionmentioning

confidence: 99%

Pancreatectomy is underused in NSW regions with low institutional surgical volumes: a population data linkage study

Creighton

Walton

Roder

et al. 2017

Medical Journal of Australia

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Objective: To examine differences in the proportions of people diagnosed with pancreatic cancer who underwent pancreatectomy, post‐operative outcomes and 5‐year survival in different New South Wales administrative health regions of residence. Design, setting and participants: Retrospective analysis of NSW data on pancreatic cancer incidence and surgery, 2005–2013. Main outcome measures: The proportion of newly diagnosed patients with pancreatic cancer who were resected in each region; 90‐day post‐operative mortality; one‐year post‐operative survival; 5‐year post‐diagnosis survival. Results: 14% of people diagnosed with pancreatic cancer during 2010–2013 (431 of 3064) underwent pancreatectomy, an average of 108 resections per year. After adjusting for age, sex and comorbidities, the proportion that underwent resection varied significantly between regions, ranging between 8% and 21% (P<0.001). Higher resection rates were not associated with higher post‐operative 90‐day mortality or lower one‐year survival (unadjusted and risk‐adjusted analyses). Higher resection rates were associated with higher 5‐year post‐diagnosis survival: the mean survival in regions with resection rates below 10% was 3.4%, compared with 7.2% in regions with rates greater than 15% (unadjusted and adjusted survival analyses; P<0.001). There was a positive association between regional resection rate and the pancreatectomy volume of hospitals during 2005–2009. An additional 32 people would be resected annually if resection rates in low rate regions were increased to the 80th percentile regional resection rate (18%). Conclusion: There is significant geographic variation in the proportion of people with pancreatic cancer undergoing pancreatectomy, and the 5‐year survival rate is higher in regions where this proportion is higher.

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“…In addition to hospital volume, high individual surgeon volume is associated with improved mortality . Patient sociodemographic factors and comorbidities influence outcomes and whether potentially curative resections are even pursued …”

Section: Introductionmentioning

confidence: 99%

Patient selection and the volume effect in pancreatic surgery: unequal benefits?

Bliss

Yang

Chau

et al. 2014

HPB

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In spite of a shift to high-volume hospitals, a substantial cohort still receives a resection outside of these centres. Patients receiving non-high-volume care demonstrate less favourable comorbidities, insurance and urgency of operation. The implications are twofold: already disadvantaged patients may not benefit from the high-volume effect; and patients predisposed to do well may contribute to observed superior outcomes at high-volume centres.

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Sociodemographics and Comorbidities Influence Decisions to Undergo Pancreatic Resection for Neoplastic Lesions

Cited by 13 publications

References 54 publications

A Population-Based Study of the Epidemiology of Pancreatic Cancer: A Brief Report

A Population-Based Study of the Epidemiology of Pancreatic Cancer: A Brief Report

Pancreatectomy is underused in NSW regions with low institutional surgical volumes: a population data linkage study

Patient selection and the volume effect in pancreatic surgery: unequal benefits?

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