Abstract 1484P
Background
Excessive waiting time intervals for the diagnosis and treatment of patients (pts) with pancreatic cancer can influence their prognosis but they remain unclear. The objective of this study was to describe time intervals for diagnostic imaging and treatment and their prognostic impact in pancreatic cancer in the Centre-Val de Loire (CVL) region.
Methods
This retrospective observational multicentre study included all cases of pancreatic cancer discussed for the first time in multidisciplinary team meetings (MTM) in 2017 in the CVL region. Key time points of the patient care pathways from clinical presentation to the beginning of treatment were collected. Data were extracted from the French national healthcare database (SNDS). A probabilistic matching was performed between clinical data of the medical records and medico-administrative data from SNDS to estimate median key times during care pathways (resected or unresected tumour). Factors associated with 1-year survival were studied using Cox modelling.
Results
A total of 324 pts (88% of total pts with MTM presentation) were matched and included. Male 54%, mean age 72 years±9.2, ECOG PS>1 19,5%, metastatic disease at diagnosis 47.4%, tumour resection 16%. At one year, 57% had died (17% in the resected group, 65% in the unresected group). The median time intervals from first medical visit to diagnostic imaging was 15 days [Q1-Q3: 8-44]. After imaging, median interval times to definite diagnosis and first treatment were 11 and 20 days, respectively. Significant prognostic factors associated with the risk of death at 1 year were ECOG PS>1 (HR 2.1 [1.4-3.0]), metastasis (HR 2.7 [1.9-3.9]), no tumour resection (HR 2.7 [1.3-5.6]), and time interval between first medical visit and diagnostic imaging ≥25 days (HR 1.7 [1.2- 2.3]).
Conclusions
Delay in access to diagnostic imaging impacted survival in pts with pancreatic cancer, regardless of tumour resection.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Department of clinic epidemiology (EpiDcliC), University Tours Hospital, Tours, France.
Funding
Centre-Val de Loire Regional health Agency.
Disclosure
T. Lecomte: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Servier; Financial Interests, Personal, Invited Speaker: Pierre Fabre; Financial Interests, Institutional, Principal Investigator: Ipsen; Financial Interests, Institutional, Principal Investigator: Astellas; Financial Interests, Institutional, Principal Investigator: ERYTHEC Pharma; Financial Interests, Institutional, Principal Investigator: AstraZeneca; Financial Interests, Personal, Advisory Board: Ipsen; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Servier; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Merck Serono. All other authors have declared no conflicts of interest.