Impact of Multidisciplinary and Radiologic Review on Outcome of Pancreatic Cancer Patients: an Observational Study (RevRadPAC)

Azienda Unità Sanitaria Locale Reggio Emilia

Status: Completed

Conditions: Pancreatic Ductal Adenocarcinoma

Treatments: Other: application of a diagnostic and therapeutic protocol (multidisciplinary discussion and radiological CT review)

Study type: Observational

Funder types: Other

Identifiers

NCT03973736

286/2018/OSS/AUSLRE

Details and patient eligibility

About

The investigators compared two different time periods respectively before and after the application of a dedicated diagnostic and therapeutic protocol for pancreatic ductal adenocarcinoma including multidisciplinary discussion and radiological review of cases, in order to evaluate the impact of the new protocol on surgical failures and overall survival.

Full description

Since 2012 in Reggio Emilia a new diagnostic and therapeutic protocol has been implemented including multidisciplinary team discussion of non-metastatic PDACs and radiological review of CT scans by an experienced radiologist.

The aim of this study is to measure the impact of this new protocol on the occurrence of surgical failures, including incomplete resection or surgery in which resection resulted impossible at all. The investigators also describe the changes in overall survival and process indicators such as the proportion of patients referred to different therapeutic options (upfront surgery, neoadjuvant chemotherapy and no surgery) and the compliance with referral.

Through a population-based cohort study, the investigators evaluated the impact of the new protocol on therapeutic management and surgical outcome of patients with non-metastatic PDAC by comparing two four-years periods, respectively 2008-2011 and 2013-2016, before and after the introduction of the protocol. Since 2012 was the transitional year when the protocol was introduced, patients diagnosed with PDAC in 2012 were excluded.

Enrollment: 316 patients

Sex: All

Ages: Under 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• all consecutive inhabitants of the Reggio Emilia province with incident PDACs in 2008-2011 and 2013-2016 periods

Exclusion criteria

• pancreatic cancers with cytohistological diagnosis different from PDAC,
• diagnosis in 2012,
• metastatic disease at diagnosis (stage IV) or unknown stage at diagnosis,
• patients aged >85 years.

Trial design

316 participants in 2 patient groups

PDAC patients diagnosed in 2008-2011

PDAC patients diagnosed in 2013-2016

Treatment:

Other: application of a diagnostic and therapeutic protocol (multidisciplinary discussion and radiological CT review)