- Author
-
T.M. Mackaij
- Title
- The Dutch Pancreatic Cancer Project
- Subtitle
- Towards nationwide improvement of outcomes
- Supervisors
-
M.G.H. Besselink
C.H.J. van Eijck - Co-supervisors
- Award date
- 11 September 2020
- Number of pages
- 318
- ISBN
- 9789463807975
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
To facilitate research and to ultimately improve outcomes on a nationwide level, the Dutch Pancreatic Cancer Project (PACAP) was launched in 2013. PACAP was an initiative of the national multidisciplinary Dutch Pancreatic Cancer Group (DPCG). PACAP includes several registries; the Netherlands Cancer Registry (NCR), Patient Reported Outcome Measures (PROMs), the surgical Dutch Pancreatic Cancer Audit (DPCA), the Dutch Pancreas Biobank (PancreasParel), and an online expert panel. This thesis describes several projects all aimed to improve outcomes for all patients with pancreatic cancer in the Netherlands by identifying differences in outcomes and points of improvement in care. First, it was investigated whether nationwide compliance to the Dutch pancreatic cancer guideline changed in the six years since its introduction. This provided a backbone for more extensive research through the different PACAP registries in Part I through the NCR and PROMs, and in Part II through the DPCA. It was demonstrated that nationwide guideline non-compliance and practice variation exist regarding cancer treatment as well as supportive care for patients with pancreatic cancer. This resulted in differences in patient outcomes, such as procedural complications, survival, and quality of life. Subsequently, a nationwide ‘best-practices’ implementation trial (PACAP-1) was developed and performed. Part III depicts the details on nationwide improvement of outcomes with the study protocol of the PACAP-1 trial and through collaboration within the DPCG.
- Note
- Author's name on cover: Tara Mackay
- Persistent Identifier
- https://hdl.handle.net/11245.1/f146c3e5-bffd-418a-a0b3-a20d16192301
- Downloads
-
Thesis (complete)
Front matter
Chapter 1: General introduction and outline of this thesis
Chapter 2: Nationwide compliance with a multidisciplinary guideline on pancreatic cancer during 6-year follow-up
Chapter 3: Association of the location of pancreatic ductal adenocarcinoma (head, body, tail) with tumor stage, treatment, and survival: A population-based analysis
Chapter 4: Association between primary origin (head, body and tail) of metastasised pancreatic ductal adenocarcinoma and oncologic outcome: A population-based analysis
Chapter 5: Implementation of contemporary chemotherapy for patients with metastatic pancreatic ductal adenocarcinoma: A population-based analysis
Chapter 6: Patient satisfaction and quality of life before and after treatment of pancreatic and periampullary cancer: A prospective multicenter study
Chapter 7: Relation between quality of life and survival in pancreatic and periampullary cancer: A multicenter cohort analysis
Chapter 8: Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer
Chapter 9: Textbook Outcome as a composite quality measure for pancreatic surgery in a nationwide prospective audit
Chapter 10: Variation in pancreatoduodenectomy as delivered in two national audits
Chapter 11: Transatlantic registries of pancreatic surgery in the USA, Germany, the Netherlands, and Sweden: Comparing design, variables, patients, treatment strategies, and outcomes
Chapter 12: The risk of not receiving adjuvant chemotherapy after resection of pancreatic ductal adenocarcinoma: A nationwide analysis
Chapter 13: Impact of nationwide enhanced implementation of best practices in pancreatic cancer care (PACAP-1): A multicenter stepped-wedge cluster randomized controlled trial
Chapter 14: Establishing and coordinating a nationwide multidisciplinary study group: Lessons learned by the Dutch Pancreatic Cancer Group
Chapter 15: Summary
Chapter 16: General discussion and future perspectives
Nederlandse samenvatting; List of contributing authors; List of publications; PhD portfolio; Dankwoord; Curriculum vitae
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