Assessment of adherence to the standard treatment guidelines among elderly patients with early stage pancreatic cancer

Pancreatic cancer has the worst prognosis among gastrointestinal cancers and poses big treatment challenges. Adherence to standard treatment guidelines improves the quality of pancreatic cancer care and its outcome. In this study, we used the Texas Cancer Registry (TCR)-linked Medicare data and Surveillance and Epidemiology End Results Program (SEER)-linked Medicare data to study the factors associated with standard treatments in patients older than 66 years who had been diagnosed as having localized pancreatic cancer between January 1, 2001 and December 31, 2009. By using cancer registry-linked Medicare claim data, we were able to assess compliance with standard treatment guidelines as well as the impact of compliance on survival rates among elderly patients with early-stage pancreatic cancer. We found that among the 1,875 patients with localized pancreatic cancer, 26.3% had undergone surgery, in compliance with the recommended treatment guidelines. Patients were more likely to undergo surgery if they were younger and female and had a higher level of education and lower comorbidity score. Patients with a localized tumor who had undergone surgery had significantly better survival than were those with a localized tumor who had not undergone surgery (P \u3c 0.0001). Although curing pancreatic cancer is currently not possible, following evidence-based practice guidelines and using the best treatment options will extend long-term survival and obtain optimal outcomes. We believe that our study will help explain why compliance with these guidelines and use of these treatment options will improve the care of patients with pancreatic cancer.