Survival and Chemotherapy in the Last 30 Days as a Quality Indicator for Pancreatic Cancer.

[BACKGROUND/AIM] This study aimed to investigate survival, treatment patterns, and the use of chemotherapy during the last 30 days of life in patients with pancreatic cancer, with the latter serving as a quality indicator.

[PATIENTS AND METHODS] The data were collected through a retrospective review of electronic patient journals. The initial cohort consisted of 163 patients coded with ICD10-C25 pancreatic cancer at Nordland hospital trust from January 2021 till August 2023. A total of 113 patients were included, of whom 86 had histologically or cytologically confirmed pancreatic ductal adenocarcinoma, while 27 were diagnosed based on radiological findings.

[RESULTS] The most common first-line chemotherapy regimen was nab-paclitaxel/gemcitabine, followed by FOLFIRINOX. The median survival was 4.0 months for all patients, 15.1 months for surgical patients, 7.0 months for patients treated with chemotherapy, and 1.5 months for patients who did not receive any treatment. Eight patients (18%) received chemotherapy during the last 30 days of life. All were treated with nab-paclitaxel/gemcitabine as first-line therapy, with an average of 0.75 treatment courses administered. Six of these patients were affiliated with small local hospitals without an oncologist present, and five were aged 75 years or older.

[CONCLUSION] Our findings largely align with the 2022 report from the Norwegian Quality Registry, though some deviations are observed due to better coverage and more detailed patient information in our study. The slightly shorter survival rates may reflect the inclusion of radiologically diagnosed patients. To establish treatment in the last 30 days of life as a quality indicator and support longitudinal quality improvement, further in-depth analysis of at-risk patients is needed.