Kulaylat AS, et al. – The trends, factors, and outcomes associated with utilization of palliative therapies were distinguished in this study. Palliation of symptoms remained underutilized in this country, particularly in non–Caucasian, older patients, despite the continued dismal prognosis of pancreatic cancer. Furthermore, increased awareness of palliative options seemed to increase its utilization.

Methods

• By receipt of palliative therapy, patients with stage IV pancreatic adenocarcinoma from the 2003–2011 U.S. National Cancer Database were identified and stratified.
• Multivariate proportional hazards models were used to perform linear regression, multivariable logistic regression, and survival analyses.

Results

• This study delineated sixty-eight thousand and seventy-five patients with stage IV disease, of which only 11,449 (16.8%) underwent designated palliative therapy.
• Systemic chemotherapy (37.2%), followed by surgery (19.0%), pain management alone (15.3%), radiation (8.1%), referral alone (11.7%), or a combination thereof (8.7%) were given to the majority.
• 12.9% in 2003 to 19.2% in 2011 (P<0.001) increase in utilization of palliative therapies, was recorded.
• It was noted that patients were less likely to undergo palliation when older than 60 (OR 0.89, P<0.001), or of black or Hispanic race (OR 0.83, P<0.001; OR 0.80, P<0.001, respectively, vs. Caucasians).
• They observed the increase in the use of palliative therapy (OR 1.16 per comorbidity, P<0.001) due to presence of comorbidities.
• Results revealed improved survival in those receiving palliative systemic chemotherapy (HR 0.55, P<0.001) and palliative surgery (HR 0.94, P<0.001).