Evidence map›Paper›PMID 36879667›Full record

ArticleSurgery open science2023

The impact of age and comorbidity on localized pancreatic cancer outcomes: A US retrospective cohort analysis with implications for surgical centralization.

Benjamin D Powers, Kelvin Allenson, Jennifer A Perone, Zachary Thompson, David Boulware, Jason W Denbo, Joon-Kyung Kim, Jennifer B Permuth, Jose Pimiento, Pamela J Hodul and 4 more

Abstract read
In one paragraph

Article in Surgery open science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Benjamin D PowersDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Kelvin AllensonDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Jennifer A PeroneDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Zachary ThompsonDepartment of Biostatistics, Moffitt Cancer Center, Tampa, FL, United States of America.
David BoulwareDepartment of Biostatistics, Moffitt Cancer Center, Tampa, FL, United States of America.
Jason W DenboDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Joon-Kyung KimUniversity of South Florida Morsani School of Medicine, Tampa, FL, United States of America.
Jennifer B PermuthDepartment of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America.
Jose PimientoDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Pamela J HodulDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Mokenge P MalafaDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Dae Won KimDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Jason B FlemingDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
Daniel A AnayaDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.

Funding

Novel Therapy to Inhibit IPMN ProgressionR01CA263575 · NCI · H. LEE MOFFITT CANCER CTR & RES INST · PI BATRA, SURINDER K., MALAFA, MOKENGE P. · 2022 to 2024
$2.1M
NCI NIH HHS R01 CA263575
6 · The paper itself

Abstract

Introduction: Age and comorbidity are independently associated with worse outcomes for pancreatic adenocarcinoma (PDAC). However, the effect of combined age and comorbidity on PDAC outcomes has rarely been studied. This study assessed the impact of age and comorbidity (CACI) and surgical center volume on PDAC 90-day and overall survival (OS). Methods: This retrospective cohort study used the National Cancer Database from 2004 to 2016 to evaluate resected stage I/II PDAC patients. The predictor variable, CACI, combined the Charlson/Deyo comorbidity score with additional points for each decade lived ≥50 years. The outcomes were 90-day mortality and OS. Results: The cohort included 29,571 patients. Ninety-day mortality ranged from 2 % for CACI 0 to 13 % for CACI 6+ patients. There was a negligible difference (1 %) in 90-day mortality between high- and low-volume hospitals for CACI 0-2 patients; however, there was greater difference for CACI 3-5 (5 % vs. 9 %) and CACI 6+ (8 % vs. 15 %). The overall survival for CACI 0-2, 3-5, and 6+ cohorts was 24.1, 19.8, and 16.2 months, respectively. Adjusted overall survival showed a 2.7 and 3.1 month survival benefit for care at high-volume vs. low-volume hospitals for CACI 0-2 and 3-5, respectively. However, there was no OS volume benefit for CACI 6+ patients. Conclusions: Combined age and comorbidity are associated with short- and long-term survival for resected PDAC patients. A protective effect of higher-volume care was more impactful for 90-day mortality for patients with a CACI above 3. A centralization policy based on volume may have greater benefit for older, sicker patients. Key message: Combined comorbidity and age are strongly associated with 90-day mortality and overall survival for resected pancreatic cancer patients. When assessing the impact of age and comorbidity on resected pancreatic adenocarcinoma outcomes, 90-day mortality was 7 % higher (8 % vs. 15 %) for older, sicker patients treated at high-volume vs. low-volume centers but only 1 % (3 % vs. 4 %) for younger, healthier patients.

Indexed as

AgeComorbiditiesPancreatic cancerSurgery

Identifiers

PMID36879667
PMCPMC9985051

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.