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Impact of centralization of pancreatic cancer surgery on resection rates and survival
- Source :
- British Journal of Surgery, 101(8), 1000-1005, British Journal of Surgery, 101(8), 1000-1005. John Wiley & Sons Ltd., British journal of surgery, 101(8), 1000-1005. John Wiley and Sons Ltd
- Publication Year :
- 2014
- Publisher :
- John Wiley & Sons Ltd., 2014.
-
Abstract
- Background Centralization of pancreatic surgery has been shown to reduce postoperative mortality. It is unknown whether resection rates and survival have also improved. The aim of this study was to analyse the impact of nationwide centralization of pancreatic surgery on resection rates and long-term survival. Methods All patients diagnosed in the Netherlands between 2000 and 2009 with cancer of the pancreatic head were identified in the Netherlands Cancer Registry. Changes in referral pattern, resection rates and survival after pancreatoduodenectomy were analysed. Multivariable regression analysis was used to assess the impact of hospital volume (20 or more procedures per year) on survival after resection. Results Between 2000 and 2009, 11 160 patients were diagnosed with cancer of the pancreatic head. The resection rate increased from 10·7 per cent in 2000–2004 to 15·3 per cent in 2005–2009 (P < 0·001). No significant difference in survival after resection was observed between the two intervals (P = 0·135), although survival was significantly better in high-volume hospitals (median survival 18 months versus 16 months in low/medium-volume hospitals; P = 0·017). After adjustment for patient and tumour characteristics, high hospital volume remained associated with better overall survival after resection (hazard ratio 0·70, 95 per cent confidence interval 0·58 to 0·84; P < 0·001). Conclusion Centralization of pancreatic cancer surgery led to increased resection rates. High-volume centres had significantly better survival rates. Centralization improves patient outcomes and should be encouraged.
- Subjects :
- Adult
Male
medicine.medical_specialty
Hospitals, Low-Volume
Multivariate analysis
Surgicenters
medicine.medical_treatment
Cancer Care Facilities
Pancreaticoduodenectomy
SDG 3 - Good Health and Well-being
Pancreatic cancer
medicine
Humans
Registries
Referral and Consultation
Survival rate
Aged
Netherlands
Aged, 80 and over
business.industry
Hazard ratio
Cancer
Middle Aged
medicine.disease
Confidence interval
Surgery
Cancer registry
Pancreatic Neoplasms
Survival Rate
Treatment Outcome
Female
business
Hospitals, High-Volume
Subjects
Details
- ISSN :
- 13652168 and 00071323
- Volume :
- 101
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- British Journal of Surgery
- Accession number :
- edsair.doi.dedup.....9f44d89325e93e12ec7b22a4fa203e7c