From Diagnosis to Treatment: Evaluating Timeliness and Treatment Patterns in Czech Pancreatic Cancer Patients
Author(s)
Gleb Donin, PhD, Radka Storchová, PhD, Juliana Müllerová, Mag, Marian Rybar, MA, Karla Mothejlová, MSc, Vladimir Rogalewicz, Prof., PhD, Zuzana Bielciková, MD, PhD, Aleš Tichopád, PhD.
Department of Biomedical Technology, Czech Technical University in Prague, Kladno, Czech Republic.
Department of Biomedical Technology, Czech Technical University in Prague, Kladno, Czech Republic.
OBJECTIVES: The aim of this study was to analyze real-world treatment patterns, timing, and care delivery for pancreatic cancer patients across the Czech healthcare system, with a focus on survival differences based on hospital surgical volume.
METHODS: We performed a retrospective analysis of Czech health administrative claims data linked with the National Oncology Registry for adult patients with primary pancreatic cancer diagnosed in 2017-2022. Index date was defined as imaging within 90 days before registry diagnosis date. We analyzed time to initiation of first-line therapy (surgery, pharmacotherapy, radiotherapy), main treatment modality within 6 months, and treatment facility type (specialized oncology centers vs. others). The Cox proportional hazards model was used to evaluate the association between hospital pancreatic surgery volume and overall survival in operated patients with stages I and II, with adjustment for age, sex, diagnosis year, and neoadjuvant therapy.
RESULTS: Among 9,760 verified patients, 5,375 (55,1%) received active treatment. The median time to initiation of first-line therapy was 53 days overall: 45 days for surgery, 56 days for pharmacologic therapy, and 78 days for radiotherapy. Surgery was performed in 71.6% of patients with Stage I-II disease and in 32.7% of those with Stage III. More than three-quarters of patients (76.2%) initiated treatment in specialized oncology centers, with a higher rate of surgical centralization (87.5%) compared to pharmacotherapy (71.0%). Significant regional variation was observed in treatment timing and specialized care utilization. Surgeries performed at low-volume hospitals were associated with worse survival outcomes (HR 1.32, 95% CI 1.09-1.59, p < 0.05) compared to those at high-volume hospitals.
CONCLUSIONS: Substantial variation exists in pancreatic cancer care across the Czech system. While ongoing centralization to specialized centers shows promise, opportunities remain to optimize care coordination, reduce treatment delays, and improve multidisciplinary care access. Volume-outcome relationships support continued centralization of pancreatic cancer surgery to high-volume hospitals.
METHODS: We performed a retrospective analysis of Czech health administrative claims data linked with the National Oncology Registry for adult patients with primary pancreatic cancer diagnosed in 2017-2022. Index date was defined as imaging within 90 days before registry diagnosis date. We analyzed time to initiation of first-line therapy (surgery, pharmacotherapy, radiotherapy), main treatment modality within 6 months, and treatment facility type (specialized oncology centers vs. others). The Cox proportional hazards model was used to evaluate the association between hospital pancreatic surgery volume and overall survival in operated patients with stages I and II, with adjustment for age, sex, diagnosis year, and neoadjuvant therapy.
RESULTS: Among 9,760 verified patients, 5,375 (55,1%) received active treatment. The median time to initiation of first-line therapy was 53 days overall: 45 days for surgery, 56 days for pharmacologic therapy, and 78 days for radiotherapy. Surgery was performed in 71.6% of patients with Stage I-II disease and in 32.7% of those with Stage III. More than three-quarters of patients (76.2%) initiated treatment in specialized oncology centers, with a higher rate of surgical centralization (87.5%) compared to pharmacotherapy (71.0%). Significant regional variation was observed in treatment timing and specialized care utilization. Surgeries performed at low-volume hospitals were associated with worse survival outcomes (HR 1.32, 95% CI 1.09-1.59, p < 0.05) compared to those at high-volume hospitals.
CONCLUSIONS: Substantial variation exists in pancreatic cancer care across the Czech system. While ongoing centralization to specialized centers shows promise, opportunities remain to optimize care coordination, reduce treatment delays, and improve multidisciplinary care access. Volume-outcome relationships support continued centralization of pancreatic cancer surgery to high-volume hospitals.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD53
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Oncology