5532e3f8f1bb9f436f9f427fb3413c6e pmc_10177886.pdf d4cd320f950be9517db09876e3ff48f42d9bca06 pmc_10177886.pdf 8a8aa35427cdda82d90fb7b8034741ea8d49cabf4933007f6ed15f04402f860a pmc_10177886.pdf Title: Management, Survival, and Costs of Pancreatic Cancer: Population-Based Observational Study in Catalonia Subject: Aim: Few published studies comprehensively describe the characteristics of patients with pancreatic cancer and their treatment in clinical practice. This study aimed to describe the current clinical practice for treating pancreatic cancer in Catalonia, along with the associated survival and treatment costs. Methods: A retrospective observational cohort study in patients diagnosed with pancreatic cancer from 2014 to 2018, using data from the healthcare records of the Public Health System of Catalonia, was conducted. Treatment patterns and costs were described by age groups from 2014 to 2018, with survival reported until December 2021. Results: The proportion of patients receiving surgery with curative intent was low, especially in older patients (23% of patients <60 years and 9% of patients 80 years). The percentage of patients treated with drugs for unresectable disease also decreased with age (45% of patients <60 years and 8% of patients 80 years). Although age was associated with significant differences in survival after curative surgery, no differences attributable to age were observed in patients who received pharmacological treatment for unresectable disease. In patients under 60 years of age, the mean cost of the first year of treatment was EUR 17,730 (standard deviation [SD] 5754) in those receiving surgery and EUR 5398 (SD 9581) in those on pharmacological treatment for unresectable disease. In patients over 80, the mean costs were EUR 15,339 (SD 2634) and EUR 1845 (SD 3413), respectively. Conclusions: Half of the patients diagnosed with pancreatic cancer did not receive specific treatment. Surgery with curative intent was associated with longer survival, but only 18% of (mostly younger) patients received this treatment. Chemotherapy was also used less frequently in patients of advanced age, though survival in treated patients was comparable across all age groups, so careful oncogeriatric assessment is advisable to ensure the most appropriate indication for eligibility in older patients. In general, earlier diagnosis and more effective pharmacological treatments are necessary to treat frail patients with high comorbidity, a common profile in older patients. Keywords: pancreatic cancer; real-world data; early diagnosis; overall survival; treatment cost; oncogeriatric Author: Laura Guarga, Noelia Paco, Paula Manchon-Walsh, Emili Vela, Joaquim Delgadillo, Caridad Pontes and Josep Maria Borràs Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Apr 28 05:48:03 2023 CEST ModDate: Fri Apr 28 05:51:39 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 9076762 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OMZDNR+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 KGBGFK+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 BSVDFG+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 23 0 WNWTFR+VnURWPalladioL-Bold Type 1 Custom yes yes no 27 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 80 0 BNGPHI+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 100 0 BNHCCB+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 106 0 BNGPIJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 109 0 BNGPIK+PalatinoLinotype CID TrueType Identity-H yes yes yes 112 0 BNGPIL+PalatinoLinotype TrueType WinAnsi yes yes no 118 0 BNGPIN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 121 0 BNHANG+PalatinoLinotype TrueType MacRoman yes yes no 124 0 BNGPIJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 144 0 BNGPIK+PalatinoLinotype CID TrueType Identity-H yes yes yes 147 0 BNGPIL+PalatinoLinotype TrueType WinAnsi yes yes no 153 0 BNGPIN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 156 0 BNHANG+PalatinoLinotype TrueType MacRoman yes yes no 159 0 BNGPHI+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 195 0 BNGPIJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 201 0 BNGPIK+PalatinoLinotype CID TrueType Identity-H yes yes yes 204 0 BNGPIL+PalatinoLinotype TrueType WinAnsi yes yes no 210 0 BNGPIN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 213 0 BNHANG+PalatinoLinotype TrueType MacRoman yes yes no 216 0 FJMGBM+VnURWPalladioL Type 1 Custom yes yes no 248 0 NPGMNZ+VnURWPalladioL-Italic Type 1 Custom yes yes no 255 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 262 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-06-26 02:46:32 CEST RepresentationInformation: pmc_10177886.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-06-20 02:38:01 CEST Size: 9076762 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 495 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Children: Item: Title: Data Source Destination: subsection.2.1 Item: Title: Study Population Destination: subsection.2.2 Item: Title: Outcomes Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Ethics Destination: subsection.2.5 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Management, Survival, and Costs of Pancreatic Cancer: Population-Based Observational Study in Catalonia Author: Laura Guarga, Noelia Paco, Paula Manchon-Walsh, Emili Vela, Joaquim Delgadillo, Caridad Pontes and Josep Maria Borràs Subject: Aim: Few published studies comprehensively describe the characteristics of patients with pancreatic cancer and their treatment in clinical practice. This study aimed to describe the current clinical practice for treating pancreatic cancer in Catalonia, along with the associated survival and treatment costs. Methods: A retrospective observational cohort study in patients diagnosed with pancreatic cancer from 2014 to 2018, using data from the healthcare records of the Public Health System of Catalonia, was conducted. Treatment patterns and costs were described by age groups from 2014 to 2018, with survival reported until December 2021. Results: The proportion of patients receiving surgery with curative intent was low, especially in older patients (23% of patients <60 years and 9% of patients 80 years). The percentage of patients treated with drugs for unresectable disease also decreased with age (45% of patients <60 years and 8% of patients 80 years). Although age was associated with significant differences in survival after curative surgery, no differences attributable to age were observed in patients who received pharmacological treatment for unresectable disease. In patients under 60 years of age, the mean cost of the first year of treatment was EUR 17,730 (standard deviation [SD] 5754) in those receiving surgery and EUR 5398 (SD 9581) in those on pharmacological treatment for unresectable disease. In patients over 80, the mean costs were EUR 15,339 (SD 2634) and EUR 1845 (SD 3413), respectively. Conclusions: Half of the patients diagnosed with pancreatic cancer did not receive specific treatment. Surgery with curative intent was associated with longer survival, but only 18% of (mostly younger) patients received this treatment. Chemotherapy was also used less frequently in patients of advanced age, though survival in treated patients was comparable across all age groups, so careful oncogeriatric assessment is advisable to ensure the most appropriate indication for eligibility in older patients. In general, earlier diagnosis and more effective pharmacological treatments are necessary to treat frail patients with high comorbidity, a common profile in older patients. 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