Pancreatic Ductal Adenocarcinoma
Conditions
Brief summary
The investigators compared two different time periods respectively before and after the application of a dedicated diagnostic and therapeutic protocol for pancreatic ductal adenocarcinoma including multidisciplinary discussion and radiological review of cases, in order to evaluate the impact of the new protocol on surgical failures and overall survival.
Detailed description
Since 2012 in Reggio Emilia a new diagnostic and therapeutic protocol has been implemented including multidisciplinary team discussion of non-metastatic PDACs and radiological review of CT scans by an experienced radiologist. The aim of this study is to measure the impact of this new protocol on the occurrence of surgical failures, including incomplete resection or surgery in which resection resulted impossible at all. The investigators also describe the changes in overall survival and process indicators such as the proportion of patients referred to different therapeutic options (upfront surgery, neoadjuvant chemotherapy and no surgery) and the compliance with referral. Through a population-based cohort study, the investigators evaluated the impact of the new protocol on therapeutic management and surgical outcome of patients with non-metastatic PDAC by comparing two four-years periods, respectively 2008-2011 and 2013-2016, before and after the introduction of the protocol. Since 2012 was the transitional year when the protocol was introduced, patients diagnosed with PDAC in 2012 were excluded.
Interventions
OTHERapplication of a diagnostic and therapeutic protocol (multidisciplinary discussion and radiological CT review)
Since the introduction of the new protocol in 2012, a single central multidisciplinary team has been formalized, with weekly discussion of cases, including different specialists from all the provincial hospitals. CT scans of discussed cases are reviewed by one of two experienced radiologists based on pre-defined criteria.
Sponsors
Azienda USL Reggio Emilia - IRCCS
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 85 Years
Healthy volunteers
No
Inclusion criteria
* all consecutive inhabitants of the Reggio Emilia province with incident PDACs in 2008-2011 and 2013-2016 periods
Exclusion criteria
* pancreatic cancers with cytohistological diagnosis different from PDAC, * diagnosis in 2012, * metastatic disease at diagnosis (stage IV) or unknown stage at diagnosis, * patients aged \>85 years.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of surgical failures on the total of eligible patients | immediately after surgery | proportion of patients with incomplete resection or who received surgery in which resection was not possible |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival | 24 months | overall survival (restricted to patients with at least 24 months follow-up) |
| proportion of patients referred to different therapeutic options | up to 1 year | proportion of patients referred to different therapeutic options (upfront surgery, neoadjuvant chemotherapy and no surgery) |
Countries
Italy
Outcome results
None listed