Pancreatic Cancer: Adjuvant Therapy at High-volume Centers Associated With Better Survival

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Survival after adjuvant therapy was  superior at high-volume centers compared with community centers in patients with resected pancreatic cancer.
Survival after adjuvant therapy was superior at high-volume centers compared with community centers in patients with resected pancreatic cancer.

Both median and 5-year overall survival after adjuvant therapy was statistically superior at high-volume centers compared with community centers in patients with resected pancreatic cancer, according to a study presented at the 2016 Gastrointestinal Cancers Symposium in San Francisco, CA.1

Although surgical outcomes for patients with resected pancreatic outcomes are known to be superior at high-volume centers, the impact of adjuvant therapy performed at high-volume centers is less understood. Therefore, researchers at Virginia Mason Medical Center in Seattle, WA, sought to examine the impact of site of adjuvant therapy administration on resected patients.

For the study, researchers analyzed data from 245 patients diagnosed with pancreatic cancer between 2003 and 2014 who had their tumors removed at a high-volume center. Of those, 57% received adjuvant therapy at a high-volume center and 43% were treated by a community oncologist.

Patient characteristics were similar between arms with respect to tumor stage and size, nodal status, resection margins, and average distance travelled to the high-volume center. However, researchers found that patients treated at community centers were older by about an average of 5 years than those treated at high-volume centers (P < .01).

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Results showed that median overall survival was high-volume centers was 44 months compared with 28 months at community centers (P < .01), and 5-year overall survival was 38.6% and 24.8%, respectively (P < .01).

“Our study supports the use of high-volume centers for all adjuvant therapy components for pancreatic cancer treated with curative intent,” the authors concluded. “Ongoing investigation of patterns of care and their impact on overall survival in pancreatic cancer is warranted.

Reference

  1. Mandelson MT, Picozzi VJ. Resected pancreatic cancer (PC): impact of adjuvant therapy (Rx) at a high-volume center (HVC) on overall survival (OS) [abstract]. J Clin Oncol. 2016;34(suppl 4S; abstr 191).

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