Biliary intervention rates during neoadjuvant therapy for adenocarcinoma of the pancreatic head

Kirkpatrick, Stacey; Gillies, Gwendolyn S; Underwood, Patrick W.; Cioffi, Jessica; Treviño, José G.; Hughes, Steven J.

doi:10.1016/j.hpb.2020.11.1147

Cited by 4 publications

(1 citation statement)

References 27 publications

(32 reference statements)

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“…Interestingly, we observed that an occurrence of BAE during NAT was associated with earlier recurrence and decreased OS after surgery. This association was also observed by Kirkpatrick et al 24 in a series of 59 patients with BLR PC who were followed for biliary complications during NAT. As with previous reports, there were no pretreatment clinicopathologic factors associated with BAE during NAT 3 .…”

Section: Discussionsupporting

confidence: 76%

Biliary Adverse Events During Neoadjuvant Therapy for Pancreatic Cancer

Thalji¹,

Fernando²,

Dua³

et al. 2023

Annals of Surgery

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Objective: To describe a high-volume experience with biliary drainage before neoadjuvant therapy (NAT) for patients with operable pancreatic cancer (PC) and characterize the association between biliary adverse events (BAEs) and patient outcome. Background: Patients with PC presenting with biliary obstruction require durable decompression before NAT. Methods: Patients with operable PC and tumor-associated biliary obstruction were examined and grouped by the presence or absence of a BAE during NAT. The incidence, timing, and management of BAEs are described, and outcomes, including the completion of all treatment and overall survival (OS), were compared. Results: Of 426 patients who received pretreatment biliary decompression, 92 (22%) experienced at least 1 BAE during NAT, and 56 (13%) required repeat intervention on their biliary stent. The median duration of NAT was 161 days for all patients and was not different in the group that experienced BAEs. The median time from initial stent placement to BAE was 64 days. An interruption in the delivery of NAT (median 7 days) occurred in 25 (6%) of 426 patients. Among 426 patients, 290 (68%) completed all NAT, including surgery: 60 (65%) of 92 patients with BAE and 230 (69%) of 334 patients without BAE (P = 0.51). Among 290 patients who completed NAT and surgery, the median OS was 39 months, 26 months for the 60 patients with BAE, and 43 months for the 230 patients without BAE (P = 0.02). Conclusions: During extended multimodal NAT for PC, 22% of patients experienced a BAE. Although BAEs were not associated with a significant interruption of treatment, patients who experienced a BAE had worse OS.

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Section: Discussionsupporting

confidence: 76%

Biliary Adverse Events During Neoadjuvant Therapy for Pancreatic Cancer

Thalji¹,

Fernando²,

Dua³

et al. 2023

Annals of Surgery

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Impact of biliary intervention rates during neoadjuvant therapy for pancreatic head adenocarcinoma

Varshney

Swami

2021

HPB

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Assessment of Caregivers’ Burden When Caring for Patients With Pancreatic and Periampullary Cancer

Fong

Teinor

Yeo

et al. 2022

JNCI: Journal of the National Cancer Institute

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Background Family and other unpaid caregivers play an active role in the recovery of individuals with pancreatic and periampullary cancer after pancreatectomy. However, little is known about caregivers’ experiences and how to better support them. Methods Caregivers accompanying patients to one-month post-pancreatectomy visits at 3 hospitals completed an electronic survey between November 2018 - February 2020. We examine measures of absenteeism and work productivity loss among the subset of caregivers who reported working-for-pay, and comparatively assess caregiver experiences by employment status. All analyses were performed as 2-sided tests. Results Of 265 caregivers approached for study participation, 240 (90.6%) enrolled. Caregivers were primarily female (70.8% female, 29.2% male) and spouses (58.3%), or adult children (25.8%) of patients, with a median age of 60 years. Of the 240 caregivers included in the study, 107 (44.6%) worked for pay. Nearly half (44.4%) of working caregivers reported being absent from work due to caregiving amounting to a 14% loss in work hours. While at work, 58.9% of working caregivers reported increased work difficulty due to caregiving. Taken together, an estimated 59.7% loss in work productivity was experienced due to caregiving in the month following pancreatectomy. After adjustment for sociodemographic factors, working (vs non-working) caregivers reported increased financial (OR = 2.32, p = 0.04) and emotional (OR = 1.93, p = 0.04) difficulties, and daily activity restrictions (OR = 1.85, p = 0.048). Conclusions Working caregivers of patients with pancreatic and periampullary cancer experience negative impacts on work and productivity, and caregiving-related financial and emotional difficulties may be amplified. This study highlights the need for workplace policies to support unpaid cancer caregiving.

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Biliary intervention rates during neoadjuvant therapy for adenocarcinoma of the pancreatic head

Cited by 4 publications

References 27 publications

Biliary Adverse Events During Neoadjuvant Therapy for Pancreatic Cancer

Biliary Adverse Events During Neoadjuvant Therapy for Pancreatic Cancer

Impact of biliary intervention rates during neoadjuvant therapy for pancreatic head adenocarcinoma

Assessment of Caregivers’ Burden When Caring for Patients With Pancreatic and Periampullary Cancer

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