A pancreatic cancer multidisciplinary clinic: Insights and outcomes

Suzanne C. Schiffman, Shira Abberbock, Sharon Winters, Cindy Valko, Jennifer Steve, Amer H. Zureikat, Herbert J. Zeh, Melissa E. Hogg

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival. Materials and methods: Pancreatic ductal adenocarcinoma cancer registry patients from 2008-2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC). Results: A total of 1408 patients were identified, 557 (40%) MDC and 851 (60%) non-MDC. MDC were more likely to be an earlier stage than non-MDC (P = 0.0005): I - 4% versus 4%, II - 54% versus 43%, III - 11% versus 9%, and IV - 32% versus 44%. MDC were younger than non-MDC (68 versus 70; P = 0.005); however, younger (<75) and older (≥75) patients were more likely to receive treatment in MDC than non-MDC. MDC were more likely to participate in trials than non-MDC (28% versus 14%; P < 0.0001). MDC were more likely to receive treatment than non-MDC (90% versus 71%; P < 0.0001). MDC were more likely to receive two (38% versus 24%; P < 0.0001) or three (12% versus 9%; P = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95% confidence interval [95% CI] 0.61-1.05; P = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95% CI 0.45-1.04; P = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95% CI, 0.62-1.07; P = 0.13). Conclusions Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial.

Original languageEnglish (US)
Pages (from-to)246-252
Number of pages7
JournalJournal of Surgical Research
Volume202
Issue number2
DOIs
StatePublished - May 15 2016
Externally publishedYes

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Pancreatic Neoplasms
Therapeutics
Neoadjuvant Therapy
Confidence Intervals
Adenocarcinoma
Survival
Disease-Free Survival
Registries
Clinical Trials
Recurrence

Keywords

  • Cancer survival
  • Clinical trials
  • Multidisciplinary clinic
  • Outcomes
  • Pancreatic cancer

ASJC Scopus subject areas

  • Surgery

Cite this

Schiffman, S. C., Abberbock, S., Winters, S., Valko, C., Steve, J., Zureikat, A. H., ... Hogg, M. E. (2016). A pancreatic cancer multidisciplinary clinic: Insights and outcomes. Journal of Surgical Research, 202(2), 246-252. https://doi.org/10.1016/j.jss.2016.01.021

A pancreatic cancer multidisciplinary clinic : Insights and outcomes. / Schiffman, Suzanne C.; Abberbock, Shira; Winters, Sharon; Valko, Cindy; Steve, Jennifer; Zureikat, Amer H.; Zeh, Herbert J.; Hogg, Melissa E.

In: Journal of Surgical Research, Vol. 202, No. 2, 15.05.2016, p. 246-252.

Research output: Contribution to journalArticle

Schiffman, SC, Abberbock, S, Winters, S, Valko, C, Steve, J, Zureikat, AH, Zeh, HJ & Hogg, ME 2016, 'A pancreatic cancer multidisciplinary clinic: Insights and outcomes', Journal of Surgical Research, vol. 202, no. 2, pp. 246-252. https://doi.org/10.1016/j.jss.2016.01.021
Schiffman SC, Abberbock S, Winters S, Valko C, Steve J, Zureikat AH et al. A pancreatic cancer multidisciplinary clinic: Insights and outcomes. Journal of Surgical Research. 2016 May 15;202(2):246-252. https://doi.org/10.1016/j.jss.2016.01.021
Schiffman, Suzanne C. ; Abberbock, Shira ; Winters, Sharon ; Valko, Cindy ; Steve, Jennifer ; Zureikat, Amer H. ; Zeh, Herbert J. ; Hogg, Melissa E. / A pancreatic cancer multidisciplinary clinic : Insights and outcomes. In: Journal of Surgical Research. 2016 ; Vol. 202, No. 2. pp. 246-252.
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abstract = "Background: The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival. Materials and methods: Pancreatic ductal adenocarcinoma cancer registry patients from 2008-2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC). Results: A total of 1408 patients were identified, 557 (40{\%}) MDC and 851 (60{\%}) non-MDC. MDC were more likely to be an earlier stage than non-MDC (P = 0.0005): I - 4{\%} versus 4{\%}, II - 54{\%} versus 43{\%}, III - 11{\%} versus 9{\%}, and IV - 32{\%} versus 44{\%}. MDC were younger than non-MDC (68 versus 70; P = 0.005); however, younger (<75) and older (≥75) patients were more likely to receive treatment in MDC than non-MDC. MDC were more likely to participate in trials than non-MDC (28{\%} versus 14{\%}; P < 0.0001). MDC were more likely to receive treatment than non-MDC (90{\%} versus 71{\%}; P < 0.0001). MDC were more likely to receive two (38{\%} versus 24{\%}; P < 0.0001) or three (12{\%} versus 9{\%}; P = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95{\%} confidence interval [95{\%} CI] 0.61-1.05; P = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95{\%} CI 0.45-1.04; P = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95{\%} CI, 0.62-1.07; P = 0.13). Conclusions Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial.",
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AU - Steve, Jennifer

AU - Zureikat, Amer H.

AU - Zeh, Herbert J.

AU - Hogg, Melissa E.

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N2 - Background: The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival. Materials and methods: Pancreatic ductal adenocarcinoma cancer registry patients from 2008-2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC). Results: A total of 1408 patients were identified, 557 (40%) MDC and 851 (60%) non-MDC. MDC were more likely to be an earlier stage than non-MDC (P = 0.0005): I - 4% versus 4%, II - 54% versus 43%, III - 11% versus 9%, and IV - 32% versus 44%. MDC were younger than non-MDC (68 versus 70; P = 0.005); however, younger (<75) and older (≥75) patients were more likely to receive treatment in MDC than non-MDC. MDC were more likely to participate in trials than non-MDC (28% versus 14%; P < 0.0001). MDC were more likely to receive treatment than non-MDC (90% versus 71%; P < 0.0001). MDC were more likely to receive two (38% versus 24%; P < 0.0001) or three (12% versus 9%; P = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95% confidence interval [95% CI] 0.61-1.05; P = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95% CI 0.45-1.04; P = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95% CI, 0.62-1.07; P = 0.13). Conclusions Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial.

AB - Background: The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival. Materials and methods: Pancreatic ductal adenocarcinoma cancer registry patients from 2008-2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC). Results: A total of 1408 patients were identified, 557 (40%) MDC and 851 (60%) non-MDC. MDC were more likely to be an earlier stage than non-MDC (P = 0.0005): I - 4% versus 4%, II - 54% versus 43%, III - 11% versus 9%, and IV - 32% versus 44%. MDC were younger than non-MDC (68 versus 70; P = 0.005); however, younger (<75) and older (≥75) patients were more likely to receive treatment in MDC than non-MDC. MDC were more likely to participate in trials than non-MDC (28% versus 14%; P < 0.0001). MDC were more likely to receive treatment than non-MDC (90% versus 71%; P < 0.0001). MDC were more likely to receive two (38% versus 24%; P < 0.0001) or three (12% versus 9%; P = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95% confidence interval [95% CI] 0.61-1.05; P = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95% CI 0.45-1.04; P = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95% CI, 0.62-1.07; P = 0.13). Conclusions Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial.

KW - Cancer survival

KW - Clinical trials

KW - Multidisciplinary clinic

KW - Outcomes

KW - Pancreatic cancer

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