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Prophylactic Pancreatectomies Carry Prohibitive Mortality at Low-Volume Centers: A California Cancer Registry Study

Published on Sep 1, 2019in World Journal of Surgery2.768
· DOI :10.1007/s00268-019-05019-6
Ann Falor Callahan1
Estimated H-index: 1
(City of Hope National Medical Center),
Philip H. G. Ituarte28
Estimated H-index: 28
(City of Hope National Medical Center)
+ 5 AuthorsLaleh G. Melstrom17
Estimated H-index: 17
(City of Hope National Medical Center)
Abstract
Background Pancreatectomy for malignancy is associated with improved outcomes when performed at high-volume centers. The goal of this study was to assess pancreatectomy outcomes for premalignant cystic lesions as a function of hospital volume.
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References22
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#1Anai N. Kothari (Loyola University Medical Center)H-Index: 9
#2Barbara A. Blanco (Loyola University Medical Center)H-Index: 4
Last. Paul C. Kuo (Loyola University Medical Center)H-Index: 57
view all 9 authors...
Background Our objective was to determine the hospital resources required for low-volume, high-quality care at high-volume cancer resection centers. Methods Patients who underwent esophageal, pancreatic, and rectal resection for malignancy were identified using Healthcare Cost and Utilization Project State Inpatient Database (Florida and California) between 2007 and 2011. Annual case volume by procedure was used to identify high- and low-volume centers. Hospital data were obtained from the Ameri...
6 CitationsSource
#1Timothy E. Newhook (University of Virginia Health System)H-Index: 9
#2Damien J. LaPar (University of Virginia Health System)H-Index: 31
Last. Victor M. Zaydfudim (University of Virginia Health System)H-Index: 3
view all 6 authors...
Objectives Patients with benign neoplasms of the pancreas are selected for pancreaticoduodenectomy if there is concern for malignant transformation. This study compares outcomes after pancreaticoduodenectomy for patients with premalignant and malignant pancreatic neoplasms.
28 CitationsSource
#1Kelsey S. LauH-Index: 2
#2Aitua SalamiH-Index: 5
Last. Daniel A. Anaya (BCM: Baylor College of Medicine)H-Index: 24
view all 11 authors...
Importance Malignant neoplasms of the hepatopancreaticobiliary (HPB) system constitute a significant public health problem worldwide. Treatment coordination for these tumors is challenging and can result in substandard care. Referral centers for HPB disease have been used as a strategy to improve postoperative outcomes, but their effect on accomplishing regionalization of care and improving quality of cancer care is not well known. Objective To evaluate the effect of implementing a multidiscipli...
20 CitationsSource
#1Joseph HilbeH-Index: 19
This entry-level text offers clear and concise guidelines on how to select, construct, interpret, and evaluate count data. Written for researchers with little or no background in advanced statistics, the book presents treatments of all major models using numerous tables, insets, and detailed modeling suggestions. It begins by demonstrating the fundamentals of modeling count data, including a thorough presentation of the Poisson model. It then works up to an analysis of the problem of overdispers...
153 Citations
#1Joseph Hilbe (ASU: Arizona State University)H-Index: 19
117 CitationsSource
#1Paul D. Colavita (Carolinas Medical Center)H-Index: 11
#2Victor B. Tsirline (Carolinas Medical Center)H-Index: 14
Last. B. Todd Heniford (Carolinas Medical Center)H-Index: 50
view all 8 authors...
Background Recent publications demonstrate regionalization of complex operations to high-volume centers (HVCs) in the USA. We hypothesize that this pattern applies to hepato-pancreato-biliary (HPB) cancer resections and improved outcomes.
24 CitationsSource
#1Joseph M. HilbeH-Index: 1
117 CitationsSource
#1Camilo Correa-Gallego (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 19
#2Richard K. G. Do (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 21
Last. Peter J. Allen (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 68
view all 11 authors...
Background Clinical decision making for patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas is challenging. Even with strict criteria for resection, most resected lesions lack high-grade dysplasia (HGD) or invasive carcinoma.
44 CitationsSource
#1James J. Farrell (Yale University)H-Index: 8
#2Carlos Fernandez-del Castillo (Harvard University)H-Index: 82
Approximately 10% of persons 70 years old or older are now diagnosed with pancreatic cysts, but it is not clear which ones require additional analysis, interventions, or follow-up. Primary care doctors rely on gastroenterologists for direction because no one wants to miss a diagnosis of pancreatic cancer, but meanwhile there is pressure to limit use of diagnostic tests and limit costs. We review the different cystic neoplasms of the pancreas and diagnostic strategies based on clinical features a...
143 CitationsSource
#1Mark P. Callery (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 48
#2Wande B. Pratt (WashU: Washington University in St. Louis)H-Index: 17
Last. Charles M. Vollmer (UPenn: University of Pennsylvania)H-Index: 40
view all 5 authors...
Background Clinically relevant postoperative pancreatic fistulas (CR-POPF) are serious inherent risks of pancreatic resection. Preoperative CR-POPF risk assessment is currently inadequate and rarely disqualifies patients who need resection. The best evaluation of risk occurs intraoperatively, and should guide fistula prevention and response measures thereafter. We sought to develop a risk prediction tool for CR-POPF that features intraoperative assessment and reveals associated clinical and econ...
301 CitationsSource
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