Facility type is associated with improved perioperative and oncologic outcomes after minimally invasive surgery for pancreatic cancer. HPB (Oxford) 2023 Aug;25(8):933-940
Date
05/07/2023Pubmed ID
37149486DOI
10.1016/j.hpb.2023.04.010Scopus ID
2-s2.0-85158153721 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: This study sought to evaluate outcome differences by facility type in patients who underwent minimally invasive surgery (MIS) for pancreatic ductal adenocarcinoma (PDAC).
METHODS: The National Cancer Database was used to identify patients with clinical stage I-III PDAC who underwent MIS from 2010 to 2019 in academic or community facilities.
RESULTS: Of 6806 patients who fulfilled inclusion criteria; 1788 (26.3%) were treated at community facilities and 5018 (74.7%) at academic facilities. Patients treated at academic facilities were more likely to receive care at a high-volume facility (62% vs. 32%, p < 0.001), undergo a Whipple (64% vs. 61%, p < 0.001), and be clinical stage II (42% vs. 38%) and III (5.6% vs. 4.9%, p = 0.001). Treatment at academic facilities was predictive of receiving neoadjuvant therapy (OR 2.08, p < 0.001), negative margin resection (OR 0.80, p = 0.004), lower 90-day mortality (OR 0.72, p = 0.02), decreased length of stay (IRR 0.96, p < 0.001), and longer OS (HR 0.88, p = 0.002).
CONCLUSION: Patients who underwent MIS for PDAC at academic facilities experienced an association with improved perioperative and oncologic outcomes than those treated in community facilities.
Author List
Servin-Rojas M, Shafique N, Sell NM, Gamblin TC, Qadan MAuthor
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Carcinoma, Pancreatic DuctalHumans
Minimally Invasive Surgical Procedures
Neoadjuvant Therapy
Pancreatic Neoplasms
Retrospective Studies
