1666P Non-metastatic cohort of the Italian Association for Medical Oncology (AIOM) guideline application in real-world: Multi-Institutional based survey of adjuvant and first-line pancreatic ductal adenocarcinoma treatment in Italy (GARIBALDI)
2023; Elsevier BV; Volume: 34; Linguagem: Inglês
10.1016/j.annonc.2023.09.2615
ISSN1569-8041
AutoresCarmine Pinto, Michèle Milella, Francesca Bergamo, Mariacristina Di Marco, Giovanni Gerardo Cardellino, Luigi Cavanna, Elisa Giommoni, Fable Zustovich, Maria Bonomi, Silvia Bozzarelli, Giovanni Vicario, Elena Parlagreco, Giovanni Luca Frassineti, Marina Macchini, Giulia Orsi, Anna Santoni, L Caldirola, Irene De Simone, Michele Reni,
Tópico(s)Cancer Diagnosis and Treatment
ResumoThe GARIBALDI study investigated the impact of oncology center volume, type, and accrual rate on the prognosis of the overall therapeutic management of patients (pts) with non-metastatic Pancreatic Ductal Adenocarcinoma (nmPDAC). Consenting treatment-naïve pts ≥ 18-year with pathological diagnosis of nmPDAC were eligible. Participating centers were categorized according to the self-declared expertise, the type and the accrual rate. Survival curves were estimated by the Kaplan–Meier method and compared by the log-rank test. Overall Survival (OS) was defined as the time from the date of medical therapy start to death for any cause. Between July 2017 and October 2019, 402 pts with nmPDAC from 44 centers were enrolled. Median age was 69 (range 36-89); 50% females; 93% ECOG PS 0-1; 33% overweight/obese; 17%, 38.7%, 44.3% with stage I, II, III, respectively; median CA19.9 177 (range 0-350,933); 17% with prior cancer history. Median diagnosis to treatment interval was 26 days. 68.4% had baseline CT >25 days before treatment start. 64% received chemotherapy upfront mainly consisting of nab-paclitaxel+gemcitabine (55%), gemcitabine alone (12%) or FOLFIRINOX (27%); 50% were submitted to surgery; 32% received radiotherapy. The median follow-up was 43.7 months and 274 pts died. The table provides the median OS estimates. Table: 1666PDeaths/NOverall survival (Median [95%CI])Log-rank p-valueSelf-declared expertise0.0036Low-volume ( 50 pts/year)174/26023.2 [19.2-27.1]Type0.0714Community hospitals108/15420.6 [16.6-23.2]Academic centers166/24822.0 [18.7-26.9]Accrual rate0.0238Low-accrual ( 50 pts/year)53/9229.3 [18.1-35.6] Open table in a new tab A statistically significant difference in OS was found based on center volume and accrual rate, while a clinical difference was highlighted based on center type.
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