Facility-Level Availability of Japanese Society of Medical Oncology Specialists and Recorded First-Line Treatment-Process Duration in Pancreatic Cancer: A Nationwide Center for Cancer Genomics and Advanced Therapeutics Registry Analysis.

内容摘要

Facility-level availability of Japanese Society of Medical Oncology (JSMO) specialists may influence care processes, but national cancer genomic medicine data rarely capture patient-level specialist involvement. We conducted a nationwide retrospective analysis of pancreatic cancer cases in the Center for Cancer Genomics and Advanced Therapeutics (C-CAT). The primary exposure was facility-level registry-listed JSMO specialist count (0-1 vs. ≥2 specialists), with ≥2 interpreted as a proxy for minimum plural specialist-team availability. The primary endpoint was time from systemic therapy start to recorded first-line treatment end. The primary cohort included 14,568 patients at 261 facilities. Median recorded first-line treatment-process duration was 5.7 months in the 0-1 specialist group and 6.4 months in the ≥2 specialist group. In the clinical plus facility-adjusted Cox model, ≥2 specialist availability was associated with a lower hazard of recorded first-line treatment end (HR 0.895, 95% CI 0.810-0.988; p = 0.028). Supportive overall survival findings did not indicate a survival advantage, reinforcing the operational nature of the primary endpoint. These findings indicate a facility-level association with an operational treatment-process endpoint, not patient-level specialist involvement, treatment efficacy, survival benefit, facility ranking, or causality. Chemotherapy-specific national database elements are needed to evaluate specialist contribution directly.