Onur C Kutlu1, Eduardo A Vega2, Omid Salehi1, Christopher Lathan3, Sunhee Kim1, Sandeep Krishnan4, Christopher Stallwood4, Olga Kozyreva3, Claudius Conrad5. 1. Department of Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA. 2. Department of Surgery, Saint Elizabeth Medical Center, Tufts University School of Medicine, Boston, MA, USA. 3. Department of Medicine, Saint Elizabeth Medical Center, Tufts University School of Medicine, Boston, MA, USA. 4. Dana Farber Cancer Institute, Harvard University School of Medicine, Boston, MA, USA. 5. Department of Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA. Electronic address: claudius.conrad@steward.org.
Abstract
BACKGROUND: This study aimed to investigate the relationship between hospital case volume, surgical approach and AC-use in patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients were divided into quartiles by institutional pancreatectomy case volume, resection type (pancreaticoduodenectomy [PD], distal pancreatectomy [DP], or total pancreatectomy [TP]) and surgical approach (laparoscopic vs. open). The rates and contributing factors of AC administration and delay >90 days were compared among volume quartiles and surgical approaches. RESULTS: This study identified 23,494 patients who had undergone pancreatectomy for PDAC between 2010 and 2016 and met inclusion criteria. After correcting for confounders, compared to low volume hospitals patients at high-case-volume hospitals had the highest rates of AC administration after PD and DP. Moreover, compared to open surgery for all resection types, laparoscopic surgery was associated with a higher rate of AC use at high and highest-case-volume hospitals and less delay to chemotherapy at high-volume hospitals. For DP, laparoscopic approach had a positive impact on AC delay >90-day at the highest volume institutions only. CONCLUSIONS: Laparoscopic surgery for pancreatic cancer leads to higher utilization and lower probability of delay of AC in high and highest volume hospitals.
BACKGROUND: This study aimed to investigate the relationship between hospital case volume, surgical approach and AC-use in patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients were divided into quartiles by institutional pancreatectomy case volume, resection type (pancreaticoduodenectomy [PD], distal pancreatectomy [DP], or total pancreatectomy [TP]) and surgical approach (laparoscopic vs. open). The rates and contributing factors of AC administration and delay >90 days were compared among volume quartiles and surgical approaches. RESULTS: This study identified 23,494 patients who had undergone pancreatectomy for PDAC between 2010 and 2016 and met inclusion criteria. After correcting for confounders, compared to low volume hospitals patients at high-case-volume hospitals had the highest rates of AC administration after PD and DP. Moreover, compared to open surgery for all resection types, laparoscopic surgery was associated with a higher rate of AC use at high and highest-case-volume hospitals and less delay to chemotherapy at high-volume hospitals. For DP, laparoscopic approach had a positive impact on AC delay >90-day at the highest volume institutions only. CONCLUSIONS: Laparoscopic surgery for pancreatic cancer leads to higher utilization and lower probability of delay of AC in high and highest volume hospitals.
Authors: Nadia N Khan; Tennille Lewin; Amy Hatton; Charles Pilgrim; Liane Ioannou; Luc Te Marvelde; John Zalcberg; Sue Evans Journal: Am J Cancer Res Date: 2022-02-15 Impact factor: 6.166
Authors: Kennedy Yao Yi Ng; Edwin Wei Xiang Chow; Bochao Jiang; Cindy Lim; Brian Kim Poh Goh; Ser Yee Lee; Jin Yao Teo; Damien Meng Yew Tan; Peng Chung Cheow; London Lucien Peng Jin Ooi; Pierce Kah Hoe Chow; Joycelyn Jie Xin Lee; Juinn Huar Kam; Ye Xin Koh; Prema Raj Jeyaraj; Ek Khoon Tan; Su Pin Choo; Chung Yip Chan; Alexander Yaw Fui Chung; David Tai Journal: Cancer Rep (Hoboken) Date: 2021-05-03