Influence of facility type on survival outcomes after pancreatectomy for pancreatic adenocarcinoma.

Although a volume-outcome relationship has been well established for pancreatectomy, little is known about differences in mortality by facility type. The objective of this study is to evaluate the impact of facility type on short-term and long-term survival outcomes for patients with pancreatic adenocarcinoma who underwent pancreatectomy and identify determinants of overall survival (OS). A cohort of 33,382 patients with Stage I-III pancreatic adenocarcinoma diagnosed between 1998 and 2011 were evaluated from the National Cancer Data Base. Clinicopathological, sociodemographic and treatment variables were compared among three facility types where patients received resection: (i) community cancer program (CCP), (ii) comprehensive community cancer program (CCCP), and (iii) academic research program (ARP). 5-year OS was calculated using the Kaplan-Meier method. Despite ARP having significantly higher percentage of poorly differentiated tumors, higher T-stage tumors, more positive lymph nodes, and greater circle distance compared to the other facilities, it had the highest 5-yr OS. The 5-yr OS for CCP, CCCP, and ARP was 11.2%, 13.2%, and 16.6%, respectively (P < 0.0001) and the median survival time (months) was 12.4, 15.6 and 19.1, respectively. Patients receiving pancreatic resection at an ARP yielded a higher 5-year OS compared to CCP or CCCP. Published by Elsevier Ltd.

Citation

Quyen D Chu, Meijiao Zhou, Prakash Peddi, Kaelen L Medeiros, Gazi B Zibari, Hosein Shokouh-Amiri, Xiao-Cheng Wu. Influence of facility type on survival outcomes after pancreatectomy for pancreatic adenocarcinoma. HPB : the official journal of the International Hepato Pancreato Biliary Association. 2017 Sep 26

PMID: 28967535

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