A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs.
A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs.
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DOI：
10.1007/s12029-015-9724-1
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发表时间：
2015-09
影响因子：
1.6
通讯作者：
Parthenaki I
中科院分区：
文献类型：
--
作者：
Carrato A;Falcone A;Ducreux M;Valle JW;Parnaby A;Djazouli K;Alnwick-Allu K;Hutchings A;Palaska C;Parthenaki I
本研究的目的是评估欧洲胰腺癌的总体负担，重点关注现实环境中的生存时间，以及该疾病导致的总体健康生活损失。真实世界的数据是从同行评审的观察性研究中检索出来的，这些研究是通过电子搜索确定的。我们进行了两项从头分析：一项是比例不足分析，用于量化胰腺癌导致的健康生命损失的比例，另一项是对欧洲每年损失的总生命年进行估计。纳入了91项研究。年龄标准化的胰腺癌发病率中位数为男性7.6 / 10万，女性4.9 / 10万。诊断后的总中位生存期为4.6个月；转移性疾病患者的中位生存期为2.8-5.7个月。比例不足分析显示，胰腺癌导致98%的健康寿命损失，诊断时的预期寿命为4.6个月，而年龄匹配的健康人群的预期寿命为15.1年。在欧洲，每年有610,000-915,000质量调整生命年（QALYs）因胰腺癌而损失。与人群标准相比，患者在验证的健康相关生活质量工具上的得分明显较低。据我们所知，这是第一个在欧洲临床试验之外系统回顾真实世界胰腺癌患者总生存期和患者预后的研究。我们的研究结果证实了国家研究报告的预后差和生存期短。胰腺癌在欧洲是一个巨大的负担，每年损失近100万生命年，受影响的个人几乎完全丧失健康生命。本文的在线版本（doi:10.1007/s12029-015-9724-1）包含补充资料，仅供授权用户使用。
The purpose of this study was to assess the overall burden of pancreatic cancer in Europe, with a focus on survival time in a real-world setting, and the overall healthy life lost to the disease. Real-world data were retrieved from peer-reviewed, observational studies identified by an electronic search. We performed two de novo analyses: a proportional shortfall analysis to quantify the proportion of healthy life lost to pancreatic cancer and an estimation of the aggregate life-years lost annually in Europe. Ninety-one studies were included. The median, age-standardised incidence of pancreatic cancer per 100,000 was 7.6 in men and 4.9 in women. Overall median survival from diagnosis was 4.6 months; median survival was 2.8–5.7 months in patients with metastatic disease. The proportional shortfall analysis showed that pancreatic cancer results in a 98 % loss of healthy life, with a life expectancy at diagnosis of 4.6 months compared to 15.1 years for an age-matched healthy population. Annually, 610,000–915,000 quality-adjusted life-years (QALYs) are lost to pancreatic cancer in Europe. Patients had significantly lower scores on validated health-related quality of life instruments versus population norms. To the best of our knowledge, this is the first study to systematically review real-world overall survival and patient outcomes of pancreatic cancer patients in Europe outside the context of clinical trials. Our findings confirm the poor prognosis and short survival reported by national studies. Pancreatic cancer is a substantial burden in Europe, with nearly a million aggregate life-years lost annually and almost complete loss of healthy life in affected individuals. The online version of this article (doi:10.1007/s12029-015-9724-1) contains supplementary material, which is available to authorized users.