PMID- 8604906
OWN - NLM
STAT- MEDLINE
DCOM- 19960515
LR  - 20220409
IS  - 0003-4932 (Print)
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 223
IP  - 3
DP  - 1996 Mar
TI  - National patterns of care for pancreatic cancer. Results of a survey by the 
      Commission on Cancer.
PG  - 261-72
AB  - BACKGROUND: The Commission on Cancer of the American College of Surgeons 
      conducted a large, national survey to assess methods of diagnosis, American Joint 
      Commission on Cancer staging, treatment, and outcome of patients with 
      adenocarcinoma of the pancreas. STUDY DESIGN: The survey questionnaire contained 
      160 questions and covered two study periods, 1983 to 1985 and 1990, for 
      time-trend analysis. Nine hundred seventy-eight institutions throughout the 
      United States voluntarily participated, contributing 8917 case reports for 1983 
      to 1985 and 8025 reports for 1990, resulting in a total of 16,942 patient 
      reports. Most, but not all, of the participating hospitals maintain approval 
      status with the Commission on Cancer of the American College of Surgeons. 
      RESULTS: The ratio of male-to-female cases was 1:1. Patient characteristics 
      including age, ethnicity, neighborhood income, type of insurance coverage, and 
      hospital characteristics--including annual caseload and type of facility (e.g., 
      teaching, community)--appeared to influence surgical multimodality treatment 
      patterns. The most common presenting symptom was abdominal pain. The reported 
      history of smoking for these patients with pancreatic cancer was higher than U.S. 
      population averages. The frequency of using abdominal computed tomography scans, 
      endoscopic retrograde cholangiopancreatography, carcinoembryonic antigen, and CA 
      19-9 during patient evaluation all increased. Time trends toward lower operative 
      mortality and more extirpative surgery were reported, as was a slightly higher 
      survival for those patients who were resected surgically. CONCLUSIONS: Pancreatic 
      cancer continues to be a disease of older patients. There were slight 
      improvements in operative mortality. For a highly selective category of patients, 
      cancer-directed surgery offers a chance for cure with excellent operative 
      mortality and acceptable complication rates, especially when performed in 
      institutions that have a 20 or greater case per year experience.
FAU - Janes, R H Jr
AU  - Janes RH Jr
AD  - University of Arkansas for Medical Sciences, Little Rock, USA.
FAU - Niederhuber, J E
AU  - Niederhuber JE
FAU - Chmiel, J S
AU  - Chmiel JS
FAU - Winchester, D P
AU  - Winchester DP
FAU - Ocwieja, K C
AU  - Ocwieja KC
FAU - Karnell, J H
AU  - Karnell JH
FAU - Clive, R E
AU  - Clive RE
FAU - Menck, H R
AU  - Menck HR
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
MH  - Adenocarcinoma/*diagnosis/mortality/*therapy
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatectomy/mortality
MH  - Pancreatic Neoplasms/*diagnosis/mortality/*therapy
MH  - *Practice Patterns, Physicians'
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
MH  - Survival Rate
MH  - Treatment Outcome
MH  - United States/epidemiology
PMC - PMC1235114
EDAT- 1996/03/01 00:00
MHDA- 2001/03/28 10:01
PMCR- 1996/09/01
CRDT- 1996/03/01 00:00
PHST- 1996/03/01 00:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1996/03/01 00:00 [entrez]
PHST- 1996/09/01 00:00 [pmc-release]
AID - 10.1097/00000658-199603000-00006 [doi]
PST - ppublish
SO  - Ann Surg. 1996 Mar;223(3):261-72. doi: 10.1097/00000658-199603000-00006.