Enhancing management of pancreatic cancer: impact of a same day multidisciplinary clinic on access to guideline-directed care.

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-07-17 DOI:10.1016/j.hpb.2025.07.012

Matthew I Ebia, Anser A Abbas, Abrahm Levi, John Davelaar, Elissa Rosenberg, Katelyn M Atkins, Mitchell Kamrava, Simon Lo, Srinivas Gaddam, Alexandra Gangi, Kambiz Kosari, Arpit Arora, Nanor Haladjian, Meghan Laszlo, Steven Oppenheim, Karen L Reckamp, Nicholas Nissen, Brent K Larson, Ashley Wachsman, Jun Gong, Cristina Ferrone, Andrew E Hendifar, Arsen Osipov

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引用次数: 0

Abstract

Background: Pancreatic cancer (PC) requires a multimodal treatment approach. We evaluated the impact of our same-day pancreatic multidisciplinary clinic (PMDC) on genetic testing, ancillary service access, treatment timelines, clinical trial enrollment, and survival.

Methods: We retrospectively compared guideline directed care, clinical metrics and outcomes in patients managed through our PMDC (n = 87; Oct 2021-June 2023) versus an age- and resectability-matched cohort from our internal registry who received standard sequential care non-PMDC (n = 87; Jan-Dec 2020).

Results: PMDC patients were significantly more likely to undergo somatic (OR 3.69, p < 0.001) and germline testing (OR 15.41, p < 0.001), receive upfront access palliative care (OR 7.86, p < 0.001) and social services (OR 4.48, p = 0.028), initiate treatment sooner (14.3 vs. 30.9 days, p = 0.002), and enroll in clinical trials (OR 2.30, p = 0.042). Among newly diagnosed metastatic PC patients, PMDC care was independently associated with improved survival (487 vs. 267 days, p = 0.021).

Conclusion: A same-day PMDC significantly improves access to guideline-recommended care and prolongs survival in patients with metastatic pancreatic cancer.

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加强胰腺癌的管理：当日多学科门诊对获得指南指导护理的影响。

背景：胰腺癌（PC）需要多模式治疗。我们评估了当日胰腺多学科临床（PMDC）对基因检测、辅助服务获取、治疗时间表、临床试验登记和生存的影响。方法：我们回顾性地比较了指南指导下的护理、临床指标和通过PMDC管理的患者的结局(n = 87；（2021年10月至2023年6月），与来自我们内部注册中心的年龄和切除率匹配的队列进行比较，这些队列接受了标准顺序护理非pmdc (n = 87；Jan-Dec 2020)。结果：PMDC患者更有可能接受躯体（OR 3.69, p < 0.001）和种系检测（OR 15.41, p < 0.001），接受前期姑息治疗（OR 7.86, p < 0.001）和社会服务（OR 4.48, p = 0.028），更早开始治疗（OR 14.3 vs. 30.9天，p = 0.002），并参加临床试验（OR 2.30, p = 0.042）。在新诊断的转移性PC患者中，PMDC护理与生存率的提高独立相关（487天vs 267天，p = 0.021）。结论：当日PMDC显著改善了转移性胰腺癌患者获得指南推荐治疗的机会，延长了患者的生存期。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).