Impact of care fragmentation on the outcomes of patients receiving neoadjuvant and adjuvant therapy for pancreatic adenocarcinoma.
Impact of care fragmentation on the outcomes of patients receiving neoadjuvant and adjuvant therapy for pancreatic adenocarcinoma.
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DOI：
10.1002/jso.26706
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发表时间：
2022-03
影响因子：
2.5
通讯作者：
Cloyd, Jordan M.
中科院分区：
文献类型：
--
作者：
Brown, Zachary J.;Labiner, Hanna E.;Shen, Chengli;Ejaz, Aslam;Pawlik, Timothy M.;Cloyd, Jordan M.
新辅助治疗 (NT) 越来越多地用于局部胰腺导管腺癌 (PDAC)。 NT 期间护理分散对 PDAC 患者预后的影响尚不清楚。从国家癌症数据库中查询了 2004 年至 2016 年间接受 NT 治疗的 I-III 期 PDAC 成年患者以及先接受手术后接受辅助治疗 (AT) 的患者。比较了接受分散护理（FC；在 > 1 家医院提供护理）与综合护理（IC；在单一机构提供护理）的患者的短期和长期结果。在胰腺切除术前接受 NT 的 6522 名患者中，3755 名（57.6%）接受 FC，2767 名（42.4%）接受 IC。虽然接受 FC 的患者开始治疗的时间较长（33.2 天与 29.7 天，p < 0.001），但中位总生存期 (OS) 没有差异（26.7 天与 26.5 个月，p = 0.6）。在先行手术后进行 AT 的患者 (n = 15 291) 中，接受 FC 的患者从诊断到接受手术的时间较长，但从手术到 AT 的时间较短，并且 OS 没有差异 (24.0 个月与 24.0 个月，p = 0.910)。尽管护理分散与局部 PDAC 患者开始和完成治疗的时间稍长有关，但长期生存结果相似。
Neoadjuvant therapy (NT) is increasingly used for localized pancreatic ductal adenocarcinoma (PDAC). The impact of care fragmentation during NT on the outcomes of patients with PDAC is unknown. Adult patients with Stage I–III PDAC who received NT and patients who underwent surgery first followed by adjuvant therapy (AT) between 2004 and 2016 were queried from the National Cancer Database. Short- and long-term outcomes were compared between patients who received fragmented care (FC; care provided at >1 hospital) versus integrated care (IC; care at a single institution). Among 6522 patients who underwent NT before pancreatectomy, 3755 (57.6%) received FC and 2767 (42.4%) received IC. While patients who received FC had a longer time to initiation of treatment (33.2 vs. 29.7 days, p < 0.001), there was no difference in median overall survival (OS) (26.7 vs. 26.5 months, p = 0.6). Among patients who underwent upfront surgery followed by AT (n = 15 291), patients who received FC had a longer time from diagnosis to undergoing surgery but less time from surgery to AT and no difference in OS (24.0 vs. 24.0 months, p = 0.910). Although care fragmentation was associated with slightly longer times to initiate and complete treatment among patients with localized PDAC, long-term survival outcomes were similar.
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影响因子：
--
作者：
Chirico A;Lucidi F;Merluzzi T;Alivernini F;Laurentiis M;Botti G;Giordano A
通讯作者：
Giordano A
影响因子：
120.7
作者：
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Fisher, Elliott S.
影响因子：
3.9
作者：
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通讯作者：
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