A257 PANCREATIC CANCER TREATMENT AND END OF LIFE OUTCOMES: A POPULATION BASED COHORT STUDY
Notice bibliographique
Résumé
Abstract Background Patients with pancreatic cancer face challenging decisions regarding treatment choices following their diagnosis and often lack data on end-of-life (EOL) outcomes. Without the available information, older patients may be undertreated, dying earlier than they would have with treatment, while others may be overtreated and exposed to aggressive measures with harmful side effects. Aims To describe survival and EOL outcomes among pancreatic cancer patients based on index cancer treatment, disease stage, and patient characteristics. Methods We conducted a population based cohort study in Ontario, Canada of patients who died from April 2010 to December 2017 and were diagnosed with pancreatic cancer prior to death. We used administrative databases to collect data on demographics, baseline health status, treatments, and outcomes. The primary exposure was index cancer treatment (no treatment, radiation, chemotherapy alone, surgery alone, and surgery with chemotherapy). The primary outcomes were mortality, health care encounters per 30 days in the last six months of life, and palliative care visits per 30 days within the last six months of life. Secondary outcomes were location of death (institution vs. community), hospitalization within the last 30 days of life, and receipt of chemotherapy within the last 30 days of life. We estimated the association between the exposure and outcomes using multivariable models, adjusting for demographics, comorbidities, and cancer stage. Hazard ratios, adjusted mean differences, and odds ratios were reported with 95% confidence intervals. Results Our cohort included 9950 adults with a median age at diagnosis of 78. 56% received no index treatment, 5% underwent radiation, 27% underwent chemotherapy alone, 7% underwent surgery alone, and 6% underwent surgery and chemotherapy. In the multivariable regression (Table and Figure), radiation, chemotherapy alone, surgery alone, and surgery with chemotherapy were all associated with decreased mortality and fewer healthcare encounters. All groups except radiation were associated with fewer palliative care visits. All treatment groups were associated with lower odds of institutional death and hospitalization within the last 30 days of life, and higher odds of chemotherapy within the last 30 days of life. Conclusions Our data, the first to provide EOL outcome estimates based on index cancer treatment, can help patients make initial treatment decisions after a diagnosis of pancreatic cancer. Multivariable regression analyses predicting primary and secondary outcomes Association between index cancer treatment and primary outcomes. Funding Agencies CIHR
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».