A pancreatic cancer multidisciplinary clinic: insights and outcomes.

Abstract Background The purpose of this study was to evaluate the impact of a multidisciplinary clinic (MDC) on the treatment of pancreatic ductal adenocarcinoma. We hypothesized that an MDC would improve trial participation, multimodality therapy, neoadjuvant therapy, time to treatment, and survival. Materials and methods Pancreatic ductal adenocarcinoma cancer registry patients from 2008–2012 were analyzed. Outcomes of patients evaluated at the MDC were compared with patients not evaluated at the MDC (non-MDC). Results A total of 1408 patients were identified, 557 (40%) MDC and 851 (60%) non-MDC. MDC were more likely to be an earlier stage than non-MDC ( P  = 0.0005): I – 4% versus 4%, II – 54% versus 43%, III – 11% versus 9%, and IV – 32% versus 44%. MDC were younger than non-MDC (68 versus 70; P  = 0.005); however, younger ( versus 14%; P versus 71%; P versus 24%; P versus 9%; P  = 0.02) therapies than non-MDC. No difference in time to first treatment in MDC than non-MDC (0.95 versus 0.92 mo; P  = 0.69). After adjusting for age, stage, and therapy, there was a trend; however, no statistical difference in disease-free survival (hazard ratio [HR] of non-MDC versus MDC 0.80; 95% confidence interval [95% CI] 0.61–1.05; P  = 0.11), time to recurrence (HR of non-MDC versus MDC 0.69; 95% CI 0.45–1.04; P  = 0.07), or overall survival (HR of non-MDC versus MDC 0.81; 95% CI, 0.62–1.07; P  = 0.13). Conclusions Patients evaluated in an MDC were more likely to receive any treatment, receive multimodality therapy, neoadjuvant therapy, and participate in a clinical trial.