Abstract | Background: Methods: This was a population-based study of patients receiving adjuvant chemotherapy after resection of pancreatic adenocarcinoma performed at ten designated hepatopancreatobiliary centres in Ontario, Canada, between 2004 and 2014. Patients were divided into those receiving chemotherapy at the same institution as surgery or a different institution from where surgery was performed. The primary outcome was overall survival (OS). Multivariable Cox regression assessed the association between OS and each chemotherapy group, adjusted for potential confounders. Results: Of 589 patients, 374 (63·5 per cent) received adjuvant chemotherapy at the same institution as surgery. After adjusting for age, sex, co-morbidity, socioeconomic status, rural living, tumour stage, margin positivity and year of surgery, the location of adjuvant chemotherapy was not independently associated with OS (hazard ratio 1·03, 95 per cent c.i. 0·85 to 1·24). For patients who underwent chemotherapy at a different institution, mean travel distance to receive chemotherapy was less (22·9 km) than that needed for surgery (106·7 km). Conclusion: After pancreatectomy for pancreatic adenocarcinoma at specialized hepatopancreatobiliary surgery centres, OS was not affected by the location of the centre delivering adjuvant chemotherapy. Receiving this treatment in a local centre reduced patients' travel burden.
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Authors | N Latchana, L Davis, N G Coburn, A Mahar, Y Liu, A Hammad, D Kagedan, M Elmi, M Siddiqui, C C Earle, J Hallet |
Journal | BJS open
(BJS Open)
Vol. 3
Issue 1
Pg. 85-94
(02 2019)
ISSN: 2474-9842 [Electronic] England |
PMID | 30734019
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adenocarcinoma
(mortality, therapy)
- Aged
- Antineoplastic Agents
(therapeutic use)
- Chemotherapy, Adjuvant
- Female
- Health Services Accessibility
(statistics & numerical data)
- Humans
- Male
- Middle Aged
- Oncology Service, Hospital
(organization & administration)
- Ontario
(epidemiology)
- Pancreatectomy
- Pancreatic Neoplasms
(mortality, therapy)
- Patient Transfer
- Registries
- Social Class
- Survival Analysis
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