Care pathway of patients with metastatic pancreatic cancer in daily practice in France: Results from the REPERE national survey

Time interval from last visit to imaging diagnosis influences outcome in pancreatic adenocarcinoma: A regional population-based study on linked medico-administrative and clinical data

“…However, our median time intervals from prior medical visit to diagnostic imaging and from diagnostic imaging to definitive diagnosis seem longer as compared to a median diagnosis time interval of 14 days reported in the French REPERE study of metastatic patients and 0.51 month (about 15 days) in another recent French population-based study. 19 , 20 However, the limitation of these two studies is that they are oligocentric and not population-based and do not accurately reflect the entire healthcare system. Similar trends were shown concerning factors associated with a shortened time interval between diagnostic imaging and first treatment for both patients with resected or unresected disease in several international studies where, however, the role of jaundice remains paradoxical, sometimes associated with delays, sometimes with shortened time intervals.…”

“…Similar trends were shown concerning factors associated with a shortened time interval between diagnostic imaging and first treatment for both patients with resected or unresected disease in several international studies where, however, the role of jaundice remains paradoxical, sometimes associated with delays, sometimes with shortened time intervals. 19 , 23 – 25 A British study specifically dedicated to the analysis of symptoms occurring prior to pancreatic cancer diagnosis highlighted diabetes, back pain and self-reported anxiety or depression as factors associated with longer diagnostic delays. 24 In our study, the delay in obtaining a definitive pathological diagnosis in the presence of a deep venous thromboembolism might be explained by the postponement of invasive explorations, in particular biopsy, due to the high risk of bleeding under anticoagulation treatment.…”

“…In France, very few studies have been carried out over the last decade, suggesting that time intervals from the first symptoms to the first specialized visit and from the first visit to the first treatment often exceed 1 month. [18][19][20] However, there are no recommendations in the Guidelines concerning time intervals in diagnostic and treatment.…”

Time intervals to diagnosis and chemotherapy do not influence survival outcome in patients with advanced pancreatic adenocarcinoma.

“…Another limitation of our study was the lack of information about the dates of first visit with the general practitioner and catheter device implantation. In daily practice, the general practitioner is often the first physician that the patient consults [35]. The point of view of patients and their general practitioner is are also an important information.…”