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. 2021 Jul 14;13(14):3515.
doi: 10.3390/cancers13143515.

Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database

Christelle de la Fouchardière  1 , Mustapha Adham  2 , Anne-Marie Marion-Audibert  3 , Antoine Duclos  4 , Claude Darcha  5 , Olivier Berthelet  6 , Valérie Hervieu  7 , Pascal Artru  8 , Hélène Labrosse  9 , Yohan Fayet  10 , Bruno Ferroud-Plattet  11 , Bruno Aublet-Cuvellier  11 , Georges Chambon  12 , Mathieu Baconnier  13 , Christine Rebischung  14 , Fadila Farsi  9 , Isabelle Ray-Coquard  15 , Charles Mastier  16 , Pierre-Jean Ternamian  17 , Nicolas Williet  18 , Emmanuel Buc  19 , Thomas Walter  20 , Andrée-Laure Herr  11
Affiliations

Management of Patients with Pancreatic Ductal Adenocarcinoma in the Real-Life Setting: Lessons from the French National Hospital Database

Christelle de la Fouchardière et al. Cancers (Basel). .

Abstract

Pancreatic ductal adenocarcinoma (PDAC) remains a major public health challenge, and faces disparities and delays in the diagnosis and access to care. Our purposes were to describe the medical path of PDAC patients in the real-life setting and evaluate the overall survival at 1 year. We used the national hospital discharge summaries database system to analyze the management of patients with newly diagnosed PDAC over the year 2016 in Auvergne-Rhône-Alpes region (AuRA) (France). A total of 1872 patients met inclusion criteria corresponding to an incidence of 22.6 per 100,000 person-year. Within the follow-up period, 353 (18.9%) were operated with a curative intent, 743 (39.7%) underwent chemo- and/or radiotherapy, and 776 (41.4%) did not receive any of these treatments. Less than half of patients were operated in a high-volume center, defined by more than 20 PDAC resections performed annually, mainly university hospitals. The 1-year survival rate was 47% in the overall population. This study highlights that a significant number of patients with PDAC are still operated in low-volume centers or do not receive any specific oncological treatment. A detailed analysis of the medical pathways is necessary in order to identify the medical and territorial determinants and their impact on the patient's outcome.

Keywords: PDAC; access to care; adenocarcinoma; disparities; expertise; medical pathway; pancreatic cancer; pancreatic surgery; real-life data; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pancreatic ductal adenocarcinoma (PDAC) in Auvergne-Rhône-Alpes, France in 2016: average annual incidence rates standardized by region of residence.
See this image and copyright information in PMC

References

    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA. Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Conroy T., Hammel P., Hebbar M., Ben Abdelghani M., Wei A.C., Raoul J.-L., Choné L., Francois E., Artru P., Biagi J.J., et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. N. Engl. J. Med. 2018;379:2395–2406. doi: 10.1056/NEJMoa1809775. - DOI - PubMed
    1. Arnold M., Rutherford M.J., Bardot A., Ferlay J., Andersson T.M.-L., Myklebust T.Å., Tervonen H., Thursfield V., Ransom D., Shack L., et al. Progress in Cancer Survival, Mortality, and Incidence in Seven High-Income Countries 1995–2014 (ICBP SURVMARK-2): A Population-Based Study. Lancet Oncol. 2019;20:1493–1505. doi: 10.1016/S1470-2045(19)30456-5. - DOI - PMC - PubMed
    1. Romain G., Boussari O., Bossard N., Remontet L., Bouvier A.-M., Mounier M., Iwaz J., Colonna M., Jooste V. French Network of Cancer Registries (FRANCIM) Time-to-Cure and Cure Proportion in Solid Cancers in France. A Population Based Study. Cancer Epidemiol. 2019;60:93–101. doi: 10.1016/j.canep.2019.02.006. - DOI - PubMed
    1. Conroy T., Desseigne F., Ychou M., Bouché O., Guimbaud R., Bécouarn Y., Adenis A., Raoul J.L., Gourgou-Bourgade S., de la Fouchardière C., et al. Groupe Tumeurs Digestives of Unicancer; PRODIGE Intergroup. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N. Engl J. Med. 2011;364:1817–1825. doi: 10.1056/NEJMoa1011923. - DOI - PubMed

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