de la Fouchardière Christelle, Adham Mustapha, Marion-Audibert Anne-Marie, Duclos Antoine, Darcha Claude, Berthelet Olivier, Hervieu Valérie, Artru Pascal, Labrosse Hélène, Fayet Yohan, Ferroud-Plattet Bruno, Aublet-Cuvellier Bruno, Chambon Georges, Baconnier Mathieu, Rebischung Christine, Farsi Fadila, Ray-Coquard Isabelle, Mastier Charles, Ternamian Pierre-Jean, Williet Nicolas, Buc Emmanuel, Walter Thomas, Herr Andrée-Laure
Medical Oncology Department, Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France.
Surgery Department, Hopital Edouard Herriot, 5 Place d'Arsonval, 69003 Lyon, France.
Cancers (Basel). 2021 Jul 14;13(14):3515. doi: 10.3390/cancers13143515.
Pancreatic ductal adenocarcinoma (PDAC) remains a major public health challenge, and faces disparities and delays in the diagnosis and access to care. Our purposes were to describe the medical path of PDAC patients in the real-life setting and evaluate the overall survival at 1 year. We used the national hospital discharge summaries database system to analyze the management of patients with newly diagnosed PDAC over the year 2016 in Auvergne-Rhône-Alpes region (AuRA) (France). A total of 1872 patients met inclusion criteria corresponding to an incidence of 22.6 per 100,000 person-year. Within the follow-up period, 353 (18.9%) were operated with a curative intent, 743 (39.7%) underwent chemo- and/or radiotherapy, and 776 (41.4%) did not receive any of these treatments. Less than half of patients were operated in a high-volume center, defined by more than 20 PDAC resections performed annually, mainly university hospitals. The 1-year survival rate was 47% in the overall population. This study highlights that a significant number of patients with PDAC are still operated in low-volume centers or do not receive any specific oncological treatment. A detailed analysis of the medical pathways is necessary in order to identify the medical and territorial determinants and their impact on the patient's outcome.
胰腺导管腺癌（PDAC）仍然是一项重大的公共卫生挑战，在诊断和获得治疗方面存在差异和延误。我们的目的是描述PDAC患者在现实生活中的就医过程，并评估其1年总生存率。我们使用国家医院出院摘要数据库系统，分析了2016年法国奥弗涅-罗讷-阿尔卑斯地区（AuRA）新诊断的PDAC患者的治疗情况。共有1872名患者符合纳入标准，发病率为每10万人年22.6例。在随访期内，353例（18.9%）接受了根治性手术，743例（39.7%）接受了化疗和/或放疗，776例（41.4%）未接受任何这些治疗。不到一半的患者在每年进行超过20例PDAC切除术的高容量中心接受手术，主要是大学医院。总体人群的1年生存率为47%。这项研究强调，相当数量的PDAC患者仍在低容量中心接受手术，或未接受任何特定的肿瘤治疗。有必要对就医过程进行详细分析，以确定医疗和地域因素及其对患者预后的影响。
