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Pancreatic Neoplasms: HELP
Articles by Elizabeth A. Burmeister
Based on 7 articles published since 2008

Between 2008 and 2019, E. A. Burmeister wrote the following 7 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Article Biliary Stenting in Patients With Pancreatic Cancer: Results From a Population-Based Cohort Study. 2018

Payne, Madeleine / Burmeister, Elizabeth A / Waterhouse, Mary / Jordan, Susan J / OʼConnell, Dianne L / Merrett, Neil D / Goldstein, David / Wyld, David / Beesley, Vanessa L / Gooden, Helen / Janda, Monika / Neale, Rachel E. · ·Pancreas · Pubmed #29215539.

ABSTRACT: OBJECTIVE: We aimed to describe management of biliary obstruction (BO) in the context of pancreatic cancer within a population-based cohort. METHODS: We examined management of BO in 1863 patients diagnosed as having pancreatic cancer in 2010/2011. We used descriptive statistics and logistic regression to describe patterns of biliary stent usage, complications and duration of patency, associations between preoperative stenting and surgical outcomes, and between patient factors and management of jaundice. RESULTS: Almost half of the people in the cohort (n = 909) were jaundiced within 12 months of diagnosis. Two-thirds of these had at least 1 stent inserted. Preoperative stenting, mostly with plastic stents, occurred for 72% of patients who experienced jaundice prior to an attempted resection but was not associated with surgical outcomes. Seventy percent of the jaundiced patients who did not have an attempted resection were stented. Metal stents were less frequently replaced within 30 days than plastic (9% vs 42%). Living in a rural area was associated with reduced likelihood of having jaundice managed. CONCLUSIONS: Plastic stents were still used frequently, despite guidelines recommending metal in most contexts. Patients living in rural areas were less likely to have BO managed. This work highlights the need to monitor current practice.

2 Article Association between pancreatic cancer patients' perception of their care coordination and patient-reported and survival outcomes. 2018

Beesley, Vanessa L / Janda, Monika / Burmeister, Elizabeth A / Goldstein, David / Gooden, Helen / Merrett, Neil D / O'Connell, Dianne L / Wyld, David K / Chan, Raymond J / Young, Jane M / Neale, Rachel E. ·Population Health Department,QIMR Berghofer Medical Research Institute,Brisbane,Queensland,Australia. · School of Public Health and Social Work,Queensland University of Technology,Brisbane,Queensland,Australia. · Department of Medical Oncology,Prince of Wales Hospital,Sydney,New South Wales,Australia. · Cancer Nursing Research Unit, University of Sydney,New South Wales,Sydney,Australia. · Discipline of Surgery,Western Sydney University,Sydney,New South Wales,Australia. · Cancer Research Division,Cancer Council of New South Wales,Sydney,New South Wales,Australia. · Department of Medical Oncology and Cancer Care Services,Royal Brisbane and Women's Hospital,Brisbane,Queensland,Australia. · RPA Institute of Academic Surgery and Surgical Outcomes Research Centre,Sydney Local Health District,Sydney,New South Wales,Australia. ·Palliat Support Care · Pubmed #28669376.

ABSTRACT: OBJECTIVE: People with pancreatic cancer have poor survival, and management is challenging. Pancreatic cancer patients' perceptions of their care coordination and its association with their outcomes have not been well-studied. Our objective was to determine if perception of care coordination is associated with patient-reported outcomes or survival. METHODS: People with pancreatic cancer who were 1-8 months postdiagnosis (52 with completed resection and 58 with no resection) completed a patient-reported questionnaire that assessed their perceptions of care coordination, quality of life, anxiety, and depression using validated instruments. Mean scores for 15 care-coordination items were calculated and then ranked from highest (best experience) to lowest (worst experience). Associations between care-coordination scores (including communication and navigation domains) and patient-reported outcomes and survival were investigated using general linear regression and Cox regression, respectively. All analyses were stratified by whether or not the tumor had been resected. RESULTS: In both groups, the highest-ranked care-coordination items were: knowing who was responsible for coordinating care, health professionals being informed about their history, and waiting times. The worst-ranked items related to: how often patients were asked about visits with other health professionals and how well they and their family were coping, knowing the symptoms they should monitor, having sufficient emotional help from staff, and access to additional specialist services. For people who had a resection, better communication and navigation scores were significantly associated with higher quality of life and less anxiety and depression. However, these associations were not statistically significant for those with no resection. Perception of cancer care coordination was not associated with survival in either group. SIGNIFICANCE OF RESULTS: Our results suggest that, while many core clinical aspects of care are perceived to be done well for pancreatic cancer patients, improvements in emotional support, referral to specialist services, and self-management education may improve patient-reported outcomes.

3 Article Factors associated with quality of care for patients with pancreatic cancer in Australia. 2016

Burmeister, Elizabeth A / O'Connell, Dianne L / Jordan, Susan J / Goldstein, David / Merrett, Neil / Wyld, David K / Beesley, Vanessa L / Gooden, Helen M / Janda, Monika / Neale, Rachel E. ·QIMR Berghofer Medical Research Institute, Brisbane, QLD elizabeth.burmeister@qimrberghofer.edu.au. · Cancer Council NSW, Sydney, NSW. · QIMR Berghofer Medical Research Institute, Brisbane, QLD. · Prince of Wales Hospital, Sydney, NSW. · University of Western Sydney, Penrith, NSW. · Royal Brisbane and Women's Hospital, Brisbane, QLD. · University of Sydney, Sydney, NSW. · Queensland University of Technology, Brisbane, QLD. ·Med J Aust · Pubmed #27852184.

ABSTRACT: OBJECTIVES: To develop a composite score for the quality of care for patients with pancreatic cancer in Australia; to determine whether it was affected by patient and health service-related factors; to assess whether the score and survival were correlated. DESIGN, PARTICIPANTS AND SETTING: We reviewed medical records of patients diagnosed with pancreatic cancer during July 2009 - June 2011 and notified to the Queensland and New South Wales cancer registries. DESIGN AND MAIN OUTCOME MEASURES: Participants were allocated proportional quality of care scores based on indicators derived from a Delphi process, ranging from 0 (lowest) to 1 (highest quality care). Associations between patient and health service-related factors and the score were tested by linear regression, and associations between the score and survival with Kaplan-Meier and Cox proportional hazards methods. RESULTS: Proportional quality of care scores were assigned to 1571 patients. Scores for patients living in rural areas were significantly lower than for those in major cities (adjusted difference, 11%; 95% CI, 8-13%); they were higher for patients in the least socio-economically disadvantaged areas (v most disadvantaged areas: 8% higher; 95% CI, 6-11%), who were younger, had better Eastern Cooperative Oncology Group performance status, or who first presented to a hospital with a high pancreatic case volume. Higher scores were associated with improved survival; after adjusting for patient-related factors, each 10 percentage point increase in the score reduced the risk of dying by 6% (hazard ratio, 0.94; 95% CI, 0.91-0.97). CONCLUSION: Geographic category of residence may influence the quality of care received by patients with pancreatic cancer, and survival could be improved if they received optimal care.

4 Article Determinants of survival and attempted resection in patients with non-metastatic pancreatic cancer: An Australian population-based study. 2016

Burmeister, E A / Waterhouse, M / Jordan, S J / O'Connell, D L / Merrett, N D / Goldstein, D / Wyld, D / Beesley, V / Gooden, H / Janda, M / Neale, R E. ·QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; The University of Queensland, Brisbane, Queensland, Australia. Electronic address: Elizabeth.Burmeister@qimrberghofer.edu.au. · QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. · Cancer Council NSW, Sydney, Australia; University of Newcastle, NSW, Australia; University of Sydney, NSW, Australia. · Western Sydney University, NSW, Australia; Bankstown Hospital, NSW, Australia. · University of New South Wales, NSW, Australia; Prince of Wales Hospital, NSW, Australia. · The University of Queensland, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Brisbane, Australia. · University of Sydney, NSW, Australia. · Queensland University of Technology, Brisbane, Australia. ·Pancreatology · Pubmed #27374480.

ABSTRACT: BACKGROUND: There are indications that pancreatic cancer survival may differ according to sociodemographic factors, such as residential location. This may be due to differential access to curative resection. Understanding factors associated with the decision to offer a resection might enable strategies to increase the proportion of patients undergoing potentially curative surgery. METHODS: Data were extracted from medical records and cancer registries for patients diagnosed with pancreatic cancer between July 2009 and June 2011, living in one of two Australian states. Among patients clinically staged with non-metastatic disease we examined factors associated with survival using Cox proportional hazards models. To investigate survival differences we examined determinants of: 1) attempted surgical resection overall; 2) whether patients with locally advanced disease were classified as having resectable disease; and 3) attempted resection among those considered resectable. RESULTS: Data were collected for 786 eligible patients. Disease was considered locally advanced for 561 (71%) patients, 510 (65%) were classified as having potentially resectable disease and 365 (72%) of these had an attempted resection. Along with age, comorbidities and tumour stage, increasing remoteness of residence was associated with poorer survival. Remoteness of residence and review by a hepatobiliary surgeon were factors influencing the decision to offer surgery. CONCLUSIONS: This study indicated disparity in survival dependent on patients' residential location and access to a specialist hepatobiliary surgeon. Accurate clinical staging is a critical element in assessing surgical resectability and it is therefore crucial that all patients have access to specialised clinical services.

5 Article Determinants of Outcomes Following Resection for Pancreatic Cancer-a Population-Based Study. 2016

Waterhouse, Mary A / Burmeister, Elizabeth A / O'Connell, Dianne L / Ballard, Emma L / Jordan, Susan J / Merrett, Neil D / Goldstein, David / Wyld, David / Janda, Monika / Beesley, Vanessa L / Payne, Madeleine E / Gooden, Helen M / Neale, Rachel E. ·QIMR Berghofer Medical Research Institute, Brisbane, Australia. · The University of Queensland, Brisbane, Australia. · Cancer Council New South Wales, Sydney, Australia. · University of Newcastle, Sydney, Australia. · University of Sydney, Sydney, Australia. · Western Sydney University, Sydney, Australia. · University of New South Wales, Sydney, Australia. · Prince of Wales Hospital, Sydney, Australia. · Royal Brisbane and Women's Hospital, Brisbane, Australia. · Queensland University of Technology, Brisbane, Australia. · QIMR Berghofer Medical Research Institute, Brisbane, Australia. rachel.neale@qimrberghofer.edu.au. ·J Gastrointest Surg · Pubmed #27184672.

ABSTRACT: BACKGROUND: Patient and health system determinants of outcomes following pancreatic cancer resection, particularly the relative importance of hospital and surgeon volume, are unclear. Our objective was to identify patient, tumour and health service factors related to mortality and survival amongst a cohort of patients who underwent completed resection for pancreatic cancer. METHODS: Eligible patients were diagnosed with pancreatic adenocarcinoma between July 2009 and June 2011 and had a completed resection performed in Queensland or New South Wales, Australia, with either tumour-free (R0) or microscopically involved margins (R1) (n = 270). Associations were examined using logistic regression (for binary outcomes) and Cox proportional hazards or stratified Cox models (for time-to-event outcomes). RESULTS: Patients treated by surgeons who performed <4 resections/year were more likely to die from a surgical complication (versus ≥4 resections/year, P = 0.04), had higher 1-year mortality (P = 0.03), and worse overall survival up to 1.5 years after surgery (adjusted hazard ratio 1.58, 95 % confidence interval 1.07-2.34). Amongst patients who had ≥1 complication within 30 days of surgery, those aged ≥70 years had higher 1-year mortality compared to patients aged <60 years. Adjuvant chemotherapy treatment improved recurrence-free survival (P = 0.01). There were no significant associations between hospital volume and mortality or survival. CONCLUSIONS: Systems should be implemented to ensure that surgeons are completing a sufficient number of resections to optimize patient outcomes. These findings may be particularly relevant for countries with a relatively small and geographically dispersed population.

6 Article Using a Delphi process to determine optimal care for patients with pancreatic cancer. 2016

Burmeister, Elizabeth A / Jordan, Susan J / O'Connell, Dianne L / Beesley, Vanessa L / Goldstein, David / Gooden, Helen M / Janda, Monika / Merrett, Neil D / Wyld, David / Neale, Rachel E / Anonymous130856. ·QIMR Berghofer Medical Research Institute. · School of Public Health. · Cancer Council NSW. · University of Newcastle. · University of New South Wales. · University of Sydney. · Prince of Wales Hospital. · Queensland University of Technology. · University of Western Sydney. · Bankstown Hospital, NSW, Australia. · Royal Brisbane and Women's Hospital, Brisbane. · School of Medicine, University of Queensland, Queensland. ·Asia Pac J Clin Oncol · Pubmed #26800012.

ABSTRACT: AIM: Overall 5-year survival for pancreatic cancer is ∼5%. Optimizing the care that pancreatic cancer patients receive may be one way of improving outcomes. The objective of this study was to establish components of care which Australian health professionals believe important to optimally manage patients with pancreatic cancer. METHODS: Using a Delphi process, a multidisciplinary panel of 250 health professionals were invited to provide a list of factors they considered important for optimal care of pancreatic cancer patients. They were then asked to score and then rescore (from one [no importance/disagree] to 10 [very important/agree]) the factors. The mean and coefficient of variation scores were calculated and categorized into three levels of importance. RESULTS: Overall, 63 (66% of those sent the final questionnaire; 25% of those initially invited) health professionals from nine disciplines completed the final scoring of 55 statements/factors encompassing themes of presentation/staging, surgery and biliary obstruction, multidisciplinary team details and oncology. Mean scores ranged from 3.7 to 9.7 with the highest related to communication and patient assessment. There was substantial intra- and interdisciplinary variation in views about MDT membership and roles. CONCLUSION: Overall, the opinions of Australian health professionals reflect international guideline recommended care; however, they identified a number of additional factors focusing on where patients should be treated, the importance of clear communication and the need for multidisciplinary care which were not included in current clinical practice guidelines. Differences in priorities between specialty groups were also identified.

7 Article Describing Patterns of Care in Pancreatic Cancer: A Population-Based Study. 2015

Burmeister, Elizabeth A / OʼConnell, Dianne L / Beesley, Vanessa L / Goldstein, David / Gooden, Helen M / Janda, Monika / Jordan, Susan J / Merrett, Neil D / Payne, Madeleine E / Wyld, David / Neale, Rachel E / Anonymous1070839. ·From the *Population Health, QIMR Berghofer Medical Research Institute; †University of Queensland, Brisbane, Queensland; ‡Cancer Research Division, Cancer Council NSW, Sydney; §University of Newcastle, Newcastle; ║Department of Medical Oncology, Prince of Wales Hospital; ¶University of New South Wales; #Sydney Nursing School, University of Sydney, Sydney, New South Wales; **Queensland University of Technology, Brisbane, Queensland; ††School of Medicine, University of Western Sydney, Sydney, New South Wales; and ‡‡Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland. ·Pancreas · Pubmed #26262591.

ABSTRACT: OBJECTIVES: Despite pancreatic cancer being the fifth highest cause of cancer death in developed regions, there is a paucity of population-based management details for patients with pancreatic cancer. The objective of this study was to reflect on current practice and outcomes to facilitate future improvement. METHODS: A comprehensive population-based patterns-of-care study in 2 Australian states was conducted. Patients diagnosed with pancreatic adenocarcinoma between July 2009 and June 2011 were identified by cancer registries, and detailed clinical data were collected from medical records. RESULTS: Data were collected for 1863 patients, 96% of those eligible. The majority resided in major cities; their median age was 72 years, and 54% were men. Over half of the cases (58%) had metastatic disease at diagnosis. Resection was attempted for 20% of patients but only completed in 15%. The uptake of adjuvant chemotherapy (76%) and the proportion alive at 1-year (22%) were higher than reported in previous population-based reports. Of those with no complete surgical resection, 43% received palliative chemotherapy. CONCLUSIONS: This population-based overview of the management of patients with pancreatic cancer suggests that, despite evidence that the proportion surviving and the use of adjuvant chemotherapy has increased, there may still be underutilization of cancer-directed therapies.