title: Surveillance of pancreatic cancer patients after surgical resection.
abstract: BACKGROUND
  There are no clear recommendations to guide posttreatment surveillance in patients with pancreatic cancer. Our goal was to describe the posttreatment surveillance patterns in patients undergoing curative-intent resection for pancreatic cancer.
  
  
  METHODS
  We used Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data (1992-2005) to identify CT scans and physician visits in patients with pancreatic cancer who underwent curative resection (n = 2393). Surveillance began 90 days after surgery, and patients were followed for 2 years at 6-month intervals. Patients were censored if they died, experienced recurrence of disease, or entered hospice.
  
  
  RESULTS
  A total of 2045 patients survived uncensored to the beginning of the surveillance period. CT scan use decreased from 20.9% of patients in month 4 to 6.4% in month 27. There was no temporal pattern in CT use to suggest regular surveillance. Twenty-three percent of patients did not receive a CT scan in the year after surgery, increasing to 42% the second year. Patients who underwent adjuvant therapy and patients diagnosed in later years had higher CT scan use over the surveillance periods. Most patients visited both a primary care physician and a cancer specialist in each 6-month surveillance period. Patients who visited cancer specialists were more likely to have any CT scan and to be scanned more frequently.
  
  
  CONCLUSIONS
  Current surveillance patterns after resection for pancreatic cancer reflect the lack of established guidelines, implying a need for evaluation and standardization of surveillance protocols. The lack of a temporal pattern in CT testing suggests that most were obtained to evaluate symptoms rather than for routine surveillance.
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA. kmsheffi@utmb.edu
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Sheffield
authors.forename: Kristen T
authors.initials: KT
authors.lastname: Crowell
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Lin
authors.forename: Clarisse
authors.initials: C
authors.lastname: Djukom
authors.forename: James S
authors.initials: JS
authors.lastname: Goodwin
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Riall
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000556:secondary / Q000601:surgery*; D000368:Aged; D002423:Cause of Death; D059186:Chemoradiotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000453:epidemiology*; D009819:Office Visits / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D011159:Population Surveillance; D011184:Postoperative Period; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology