Changing patterns of care for pancreas cancer in Victoria: the 2022 Pancreas Tumour Summit

Pilgrim, CHC; Finn, N; Stuart, E; Philip, J; Steel, S; Croagh, D; Lee, B; Tebbutt, NC

Author(s): Pilgrim, CHC; Finn, N; Stuart, E; Philip, J; Steel, S; Croagh, D; Lee, B; Tebbutt, NC;
Details: Publication Year 2023-11,Volume 93,Issue #11,Page 2638-2647
Journal Title: ANZ Journal of Surgery
Abstract: BACKGROUND: The Victorian Government convened the second Pancreas Cancer Summit in 2021 to identify unwarranted variation in care 2016-2019, and to assess trends compared with the first Summit 2017 (reporting 2011-2015). State-wide administrative data were assessed at population level in alignment with optimal care pathways across all stages of the cancer care continuum. METHODS: Data linkage performed by Centre for Victorian Data Linkage combined data from Victorian Cancer Registry with other administrative data sets including Victorian Admitted Episodes Dataset, Victorian Radiotherapy Minimum Data Set, Victorian Emergency Minimum Dataset and Victorian Death Index. A Cancer Service Performance Indicator audit was carried out providing an in-depth analysis of identified areas of interest. RESULTS: Of 3138 Victorians diagnosed with pancreas ductal adenocarcinoma 2016-2019, 63% were metastatic at diagnosis. One-year survival increased between time periods, from 29.7% overall 2011-2015 (59.1% for non-metastatic, and 15.1% metastatic) to 32.5% overall 2016-2019 (P < 0.001), 61.2% non-metastatic (P = 0.008), 15.7% metastatic (P = NS). A higher proportion of non-metastatic patients progressed to surgery (35% vs. 31%, P = 0.020), and more received neoadjuvant therapy (16% vs. 4%, P < 0.001). Postoperative mortality following pancreatectomy at 30 and 90 days remained low at 2%. Utilization of 5FU-based chemotherapy regimens increased between 2016 and 2020. Multidisciplinary Meeting (MDM) presentation was still below the 85% target (74%) as was supportive care screening (39%, target 80%). CONCLUSIONS: Surgical outcomes remain world-class and there has been an appropriate shift in chemotherapy administration towards neoadjuvant timing with increasing use of 5FU-based regimens. MDM presentation rates, supportive care and overall care coordination remain areas of deficiency.
Publisher: Wiley
Keywords: Humans; *Hospitalization; *Pancreatic Neoplasms/epidemiology/therapy; Fluorouracil; hepatopancreaticobiliary surgery; outcomes; pancreas; pancreas cancer; surgical oncology
Research Division(s): Personalised Oncology
PubMed ID: 37221964
Publisher's Version: https://doi.org/10.1111/ans.18522
Open Access at Publisher's Site: https://doi.org/ 10.1111/ans.18522
Terms of Use/Rights Notice: Refer to copyright notice on published article.
Documents: ANZ Journal of Surgery - 2023 - Pilgrim - Changing patterns of care for pancreas cancer in Victoria the 2022 Pancreas.pdf - (1.38MB, application/pdf)

Creation Date: 2023-12-04 01:35:31

Last Modified: 2023-12-04 01:37:57