Current clinical practice in the management of Brazilian patients with potentially resectable pancreatic ductal adenocarcinoma (PDAC)

Author:

de Jesus Victor Hugo Fonseca123,Peixoto Renata D'Alpino4,Ribeiro Héber Salvador de Castro5,Pinheiro Rodrigo Nascimento6ORCID,Oliveira Alexandre Ferreira7,Anghinoni Marciano8,Torres Silvio Melo5ORCID,Boff Márcio Fernando9,Weschenfelder Rui10,Prolla Gabriel11,Riechelmann Rachel P.12

Affiliation:

1. Medical Oncology Unit Grupo Oncolínicas Florianópolis Florianópolis Santa Catarina Brazil

2. Medical Oncology Department Centro de Pesquisas Oncológicas (CEPON) Florianópolis Santa Catarina Brazil

3. Post‐Graduate Program A.C. Camargo Cancer São Paulo Sao Paulo Brazil

4. Medical Oncology Unit Grupo Oncoclínicas/Centro Paulista de Oncologia São Paulo São Paulo Brazil

5. Department of Abdominal Surgery A.C. Camargo Cancer São Paulo São Paulo Brazil

6. Surgical Oncology Unit Hospital de Base do Distrito Federal Brasília Distrito Federal Brazil

7. Oncology Unit Universidade Federal de Juiz de Fora Juiz de Fora Minas Gerais Brazil

8. Surgical Oncology Unit Centro de Oncologia do Paraná (Oncoville) Curitiba Paraná Brazil

9. Surgical Oncology Unit Hospital Mãe de Deus Porto Alegre Rio Grande do Sul Brazil

10. Department of Medical Oncology Hospital Moinho de Vento Porto Alegre Rio Grande do Sul Brazil

11. Grupo Oncoclínicas Porto Alegre Porto Alegre Rio Grande do Sul Brazil

12. Department of Medical Oncology A.C. Camargo Cancer São Paulo São Paulo Brazil

Abstract

AbstractBackground and ObjectivesWe aimed to describe the routine clinical practice of physicians involved in the treatment of patients with localized pancreatic ductal adenocarcinoma (PDAC) in Brazil.MethodsPhysicians were invited through email and text messages to participate in an electronic survey sponsored by the Brazilian Gastrointestinal Tumor Group (GTG) and the Brazilian Society of Surgical Oncology (SBCO). We evaluated the relationship between variable categories numerically with false discovery rate‐adjusted Fisher's exact test p values and graphically with Multiple Correspondence Analysis.ResultsOverall, 255 physicians answered the survey. Most (52.5%) were medical oncologists, treated patients predominantly in the private setting (71.0%), and had access to multidisciplinary tumor boards (MTDTB; 76.1%). Medical oncologists were more likely to describe neoadjuvant therapy as beneficial in the resectable setting and surgeons in the borderline resectable setting. Most physicians would use information on risk factors for early recurrence, frailty, and type of surgery to decide treatment strategy. Doctors working predominantly in public institutions were less likely to have access to MTDTB and to consider FOLFIRINOX the most adequate regimen in the neoadjuvant setting.ConclusionsConsiderable differences exist in the management of localized PDAC, some of them possibly explained by the medical specialty, but also by the funding source of health care.

Publisher

Wiley

Subject

Oncology,General Medicine,Surgery

Reference48 articles.

1. GLOBOCAN. Cancer Today: World. Accessed May 16 2023. 2023.https://gco.iarc.fr/today

2. Estimated projection of US cancer incidence and death to 2040;Rahib L;JAMA Netw Open,2021

3. Current treatment of potentially resectable pancreatic ductal adenocarcinoma: a medical oncologist's perspective;Jesus VHF;Cancer Control,2023

4. Neoadjuvant therapy or upfront surgery for resectable and borderline resectable pancreatic cancer: a meta‐analysis of randomised controlled trials;Dam JL;Eur J Cancer,2022

5. National Comprehensive Cancer Network. Pancreatic Adenocarcinoma (Version 1.). Accessed May 16 2023. 2023.https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf

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