1. Resection rate, hospital procedure volume and survival in pancreatic cancer patients in England: Population-based study, 2005-2009
- Author
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Henrik Møller, Ruth H Jack, J. Konfortion, Victoria H. Coupland, Margreet Lüchtenborg, Sharma P. Riaz, Hemant M. Kocher, and William H. Allum
- Subjects
Male ,medicine.medical_specialty ,Hospitals, Low-Volume ,Survival ,Population ,Comorbidity ,030230 surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Internal medicine ,Pancreatic cancer ,Medicine ,Population resection rate ,Humans ,education ,Survival rate ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Proportional hazards model ,Mortality rate ,Hazard ratio ,Age Factors ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Survival Rate ,Oncology ,England ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,Hospital procedure volume ,Female ,business ,Hospitals, High-Volume - Abstract
Objective: We assessed the association between population resection rates, hospital procedure volume and death rates in pancreatic cancer patients in England. Design: Patients diagnosed with pancreatic cancer were identified from a linked cancer registration and Hospital Episode Statistics dataset. Cox regression analyses were used to assess all-cause mortality according to resection quintile and hospital volume, adjusting for sex, age, deprivation and comorbidity. Results: There were 31,973 pancreatic cancer patients studied, 2580 had surgery. Increasing resection rates were associated with lower mortality among all patients (chi(2)(1df) = 176.18, p(trend) < 0.001), with an unadjusted hazard ratio (HR) of 0.78 95%CI [0.75 to 0.81] in the highest versus the lowest resection quintile. Adjustment changed the estimate slightly (HR 0.82, 95%CI [0.79 to 0.85], (chi(2)(1df) = 99.44, P-trend < 0.001)). Among patients that underwent surgery, higher procedure volume was associated with lower mortality (HR = 0.88 95%CI [0.75-1.03] in hospitals carrying out 30+ versus
- Published
- 2015