Resection of pancreatic cancer in Europe and USA: an international large-scale study highlighting large variations.
Gut
; 68(1): 130-139, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-29158237
ABSTRACT
OBJECTIVE:
Resection can potentially cure resectable pancreatic cancer (PaC) and significantly prolong survival in some patients. This large-scale international study aimed to investigate variations in resection for PaC in Europe and USA and determinants for its utilisation.DESIGN:
Data from six European population-based cancer registries and the US Surveillance, Epidemiology, and End Results Program database during 2003-2016 were analysed. Age-standardised resection rates for overall and stage I-II PaCs were computed. Associations between resection and demographic and clinical parameters were assessed using multivariable logistic regression models.RESULTS:
A total of 153 698 records were analysed. In population-based registries in 2012-2014, resection rates ranged from 13.2% (Estonia) to 21.2% (Slovenia) overall and from 34.8% (Norway) to 68.7% (Denmark) for stage I-II tumours, with great international variations. During 2003-2014, resection rates only increased in USA, the Netherlands and Denmark. Resection was significantly less frequently performed with more advanced tumour stage (ORs for stage III and IV versus stage I-II tumours 0.05-0.18 and 0.01-0.06 across countries) and increasing age (ORs for patients 70-79 and ≥80 versus those <60 years 0.37-0.63 and 0.03-0.16 across countries). Patients with advanced-stage tumours (stage III-IV 63.8%-81.2%) and at older ages (≥70 years 52.6%-59.5%) receiving less frequently resection comprised the majority of diagnosed cases. Patient performance status, tumour location and size were also associated with resection application.CONCLUSION:
Rates of PaC resection remain low in Europe and USA with great international variations. Further studies are warranted to explore reasons for these variations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Padrões de Prática Médica
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
/
Europa
Idioma:
En
Revista:
Gut
Ano de publicação:
2019
Tipo de documento:
Article