Publication Abstract

Authors: Krzyzanowska MK, Weeks JC, Earle CC

Title: Treatment of locally advanced pancreatic cancer in the real world: population-based practices and effectiveness.

Journal: J Clin Oncol 21(18):3409-14

Date: 2003 Sep 15

Abstract: PURPOSE: To evaluate the use and effectiveness of cancer-directed therapy in elderly patients with locally advanced pancreatic cancer (LAPC). METHODS: We used the linked Surveillance, Epidemiology, and End Results Medicare database to perform a retrospective cohort study in 1,696 patients diagnosed with LAPC between 1991 and 1996. We calculated cancer-directed treatment use rates, then used logistic regression to identify patient and health system factors that were associated with receipt of treatment. Effectiveness of treatment was estimated using Cox proportional hazards models and propensity score methods. RESULTS: In our cohort, 44% of patients received some form of cancer-directed therapy (24% radiation with concurrent chemotherapy, 13% radiation alone, and 7% chemotherapy alone). Older age, lower socioeconomic status, presence of comorbid illness, no care in a teaching hospital, and residence in the western United States were associated with a lower likelihood of receiving treatment (P