EUS and survival in patients with pancreatic cancer: a population-based study

Saowanee Ngamruengphong, Feng Li, Ying Zhou, Amitabh Chak, Gregory S. Cooper, Ananya Das

Research output: Contribution to journalArticle

Abstract

Background: There is no direct evidence that EUS improves patient outcome. Objective: To study the association of undergoing EUS with survival in patients with pancreatic adenocarcinoma. Design: Population-based study. Patients: Persons aged 65 years and older with a diagnosis of pancreatic cancer who were captured in the linked Surveillance Epidemiology and End Results-Medicare database between 1994 and 2002 were identified. Interventions: Demographic, cancer-specific, and EUS procedural information was extracted, and survival curves were compared for patients who underwent EUS in the peridiagnostic period (1 month before the diagnosis to 3 months after the date of diagnosis: group I) with those who had not undergone EUS (group II). Main Outcome Measurements: Relative hazard ratios for survival. Results: A total of 8616 patients with pancreatic adenocarcinoma were identified. Only 610 (7.1%) patients underwent EUS evaluation. In patients with locoregional cancer, the median survival (interquartile range) in group I and II patients was 10 (5-17) and 6 (2-12) months, respectively, P < .0001. There were more patients with early-stage disease in group I than group II (69.3% vs 36.2%, P < .001). Curative-intent surgery, chemotherapy, and radiation therapy were also performed more frequently in the patients in group I. Undergoing EUS, adjusted for age, race, sex, tumor stage, curative-intent surgery, chemotherapy, radiation therapy, and comorbidity score, was an independent predictor of improved survival (relative hazard, 0.71; 95% CI, 0.63-0.79). Limitations: Retrospective design. Conclusions: EUS evaluation is independently associated with improved outcome in patients with locoregional pancreatic cancer, possibly because of detection of earlier cancers and improved stage-appropriate management including more selective performance of curative-intent surgery.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume72
Issue number1
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

Pancreatic Neoplasms
Survival
Population
Adenocarcinoma
Radiotherapy
Drug Therapy
Neoplasms
Medicare
Early Detection of Cancer
Comorbidity
Epidemiology
Demography
Databases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

EUS and survival in patients with pancreatic cancer : a population-based study. / Ngamruengphong, Saowanee; Li, Feng; Zhou, Ying; Chak, Amitabh; Cooper, Gregory S.; Das, Ananya.

In: Gastrointestinal Endoscopy, Vol. 72, No. 1, 2010.

Research output: Contribution to journalArticle

Ngamruengphong, Saowanee ; Li, Feng ; Zhou, Ying ; Chak, Amitabh ; Cooper, Gregory S. ; Das, Ananya. / EUS and survival in patients with pancreatic cancer : a population-based study. In: Gastrointestinal Endoscopy. 2010 ; Vol. 72, No. 1.
@article{d01e8266c31f45f58789884e24b0a247,
title = "EUS and survival in patients with pancreatic cancer: a population-based study",
abstract = "Background: There is no direct evidence that EUS improves patient outcome. Objective: To study the association of undergoing EUS with survival in patients with pancreatic adenocarcinoma. Design: Population-based study. Patients: Persons aged 65 years and older with a diagnosis of pancreatic cancer who were captured in the linked Surveillance Epidemiology and End Results-Medicare database between 1994 and 2002 were identified. Interventions: Demographic, cancer-specific, and EUS procedural information was extracted, and survival curves were compared for patients who underwent EUS in the peridiagnostic period (1 month before the diagnosis to 3 months after the date of diagnosis: group I) with those who had not undergone EUS (group II). Main Outcome Measurements: Relative hazard ratios for survival. Results: A total of 8616 patients with pancreatic adenocarcinoma were identified. Only 610 (7.1{\%}) patients underwent EUS evaluation. In patients with locoregional cancer, the median survival (interquartile range) in group I and II patients was 10 (5-17) and 6 (2-12) months, respectively, P < .0001. There were more patients with early-stage disease in group I than group II (69.3{\%} vs 36.2{\%}, P < .001). Curative-intent surgery, chemotherapy, and radiation therapy were also performed more frequently in the patients in group I. Undergoing EUS, adjusted for age, race, sex, tumor stage, curative-intent surgery, chemotherapy, radiation therapy, and comorbidity score, was an independent predictor of improved survival (relative hazard, 0.71; 95{\%} CI, 0.63-0.79). Limitations: Retrospective design. Conclusions: EUS evaluation is independently associated with improved outcome in patients with locoregional pancreatic cancer, possibly because of detection of earlier cancers and improved stage-appropriate management including more selective performance of curative-intent surgery.",
author = "Saowanee Ngamruengphong and Feng Li and Ying Zhou and Amitabh Chak and Cooper, {Gregory S.} and Ananya Das",
year = "2010",
doi = "10.1016/j.gie.2010.01.072",
language = "English (US)",
volume = "72",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - EUS and survival in patients with pancreatic cancer

T2 - a population-based study

AU - Ngamruengphong, Saowanee

AU - Li, Feng

AU - Zhou, Ying

AU - Chak, Amitabh

AU - Cooper, Gregory S.

AU - Das, Ananya

PY - 2010

Y1 - 2010

N2 - Background: There is no direct evidence that EUS improves patient outcome. Objective: To study the association of undergoing EUS with survival in patients with pancreatic adenocarcinoma. Design: Population-based study. Patients: Persons aged 65 years and older with a diagnosis of pancreatic cancer who were captured in the linked Surveillance Epidemiology and End Results-Medicare database between 1994 and 2002 were identified. Interventions: Demographic, cancer-specific, and EUS procedural information was extracted, and survival curves were compared for patients who underwent EUS in the peridiagnostic period (1 month before the diagnosis to 3 months after the date of diagnosis: group I) with those who had not undergone EUS (group II). Main Outcome Measurements: Relative hazard ratios for survival. Results: A total of 8616 patients with pancreatic adenocarcinoma were identified. Only 610 (7.1%) patients underwent EUS evaluation. In patients with locoregional cancer, the median survival (interquartile range) in group I and II patients was 10 (5-17) and 6 (2-12) months, respectively, P < .0001. There were more patients with early-stage disease in group I than group II (69.3% vs 36.2%, P < .001). Curative-intent surgery, chemotherapy, and radiation therapy were also performed more frequently in the patients in group I. Undergoing EUS, adjusted for age, race, sex, tumor stage, curative-intent surgery, chemotherapy, radiation therapy, and comorbidity score, was an independent predictor of improved survival (relative hazard, 0.71; 95% CI, 0.63-0.79). Limitations: Retrospective design. Conclusions: EUS evaluation is independently associated with improved outcome in patients with locoregional pancreatic cancer, possibly because of detection of earlier cancers and improved stage-appropriate management including more selective performance of curative-intent surgery.

AB - Background: There is no direct evidence that EUS improves patient outcome. Objective: To study the association of undergoing EUS with survival in patients with pancreatic adenocarcinoma. Design: Population-based study. Patients: Persons aged 65 years and older with a diagnosis of pancreatic cancer who were captured in the linked Surveillance Epidemiology and End Results-Medicare database between 1994 and 2002 were identified. Interventions: Demographic, cancer-specific, and EUS procedural information was extracted, and survival curves were compared for patients who underwent EUS in the peridiagnostic period (1 month before the diagnosis to 3 months after the date of diagnosis: group I) with those who had not undergone EUS (group II). Main Outcome Measurements: Relative hazard ratios for survival. Results: A total of 8616 patients with pancreatic adenocarcinoma were identified. Only 610 (7.1%) patients underwent EUS evaluation. In patients with locoregional cancer, the median survival (interquartile range) in group I and II patients was 10 (5-17) and 6 (2-12) months, respectively, P < .0001. There were more patients with early-stage disease in group I than group II (69.3% vs 36.2%, P < .001). Curative-intent surgery, chemotherapy, and radiation therapy were also performed more frequently in the patients in group I. Undergoing EUS, adjusted for age, race, sex, tumor stage, curative-intent surgery, chemotherapy, radiation therapy, and comorbidity score, was an independent predictor of improved survival (relative hazard, 0.71; 95% CI, 0.63-0.79). Limitations: Retrospective design. Conclusions: EUS evaluation is independently associated with improved outcome in patients with locoregional pancreatic cancer, possibly because of detection of earlier cancers and improved stage-appropriate management including more selective performance of curative-intent surgery.

UR - http://www.scopus.com/inward/record.url?scp=77953903973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953903973&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2010.01.072

DO - 10.1016/j.gie.2010.01.072

M3 - Article

C2 - 20620274

AN - SCOPUS:77953903973

VL - 72

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 1

ER -