Medical Oncology Dept, IRCCS Ospedale San Raffaele, Università Vita e Salute, Milan, Italy.
Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Pancreatology. 2024 Nov;24(7):1160-1166. doi: 10.1016/j.pan.2024.10.002. Epub 2024 Oct 3.
This analysis from the GARIBALDI study was aimed to address the role of center self-declared expertise, type and commitment on the overall survival (OS) of patients with metastatic Pancreatic Ductal Adenocarcinoma (mPDAC). Treatment-naïve patients ≥18-year with pathological diagnosis of mPDAC were enrolled. OS was defined as the time from chemotherapy start to death from any cause. The impact of clinical-demographic and centers characteristics on OS was evaluated using Cox models. Between July 2017 and October 2019, 473 patients enrolled in 43 centers were eligible for this analysis. Median age was 69.3 (first-third quartile 61.2-74.5); 46.1 % females; 90.8 % ECOG PS 0-1; 67.4 % had liver metastases; median CA19.9700.5 UI/mL (first-third quartile 77.5-6629.5). For 37.1 % of patients chemotherapy started <4 weeks from diagnosis; 69.9 % of patients received nab-paclitaxel + gemcitabine; 16.9 % gemcitabine alone; 7.6 % FOLFIRINOX. The median follow-up was 51.8 months and 428 patients died. No statistically significant role of the type of institution was observed. Additionally, no statistically significant role of neither the self-declared expertise nor the accrual rate was observed. The GARIBALDI study suggests that the self-declared center expertise and the academic brand are not associated to OS in patients with mPDAC, while center commitment warrants further exploration.
这项来自 GARIBALDI 研究的分析旨在探讨中心自报的专业知识、类型和承诺对转移性胰腺导管腺癌(mPDAC)患者总生存期(OS)的影响。研究纳入了 18 岁及以上、病理诊断为 mPDAC、未经治疗的患者。OS 定义为从化疗开始到任何原因死亡的时间。使用 Cox 模型评估临床-人口统计学和中心特征对 OS 的影响。2017 年 7 月至 2019 年 10 月,43 个中心共纳入 473 例符合条件的患者进行了此项分析。中位年龄为 69.3 岁(第一至第三四分位数为 61.2-74.5);46.1%为女性;90.8%的 ECOG PS 为 0-1;67.4%有肝转移;中位 CA19.9700.5 UI/mL(第一至第三四分位数为 77.5-6629.5)。37.1%的患者在诊断后<4 周开始化疗;69.9%的患者接受nab-紫杉醇+吉西他滨治疗;16.9%的患者单独接受吉西他滨治疗;7.6%的患者接受 FOLFIRINOX 方案。中位随访时间为 51.8 个月,428 例患者死亡。研究未观察到机构类型的作用有统计学意义。此外,中心自报的专业知识和入组率也没有统计学意义。GARIBALDI 研究表明,在 mPDAC 患者中,中心的自我宣称的专业知识和学术品牌与 OS 无关,而中心的承诺值得进一步研究。