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Factors leading to pancreatic resection in patients with pancreatic cancer: a national perspective
Journal article   Open access

Factors leading to pancreatic resection in patients with pancreatic cancer: a national perspective

David T. Pointer, Zaid Al-Qurayshi, John B. Hamner, Douglas P. Slakey and Emad Kandil
Gland surgery, Vol.7(2), pp.207-215
04/01/2018
DOI: 10.21037/gs.2017.12.04
PMCID: PMC5938269
PMID: 29770314
url
https://europepmc.org/articles/pmc5938269View
Published (Version of record) Open Access

Abstract

Background: Resection is the only option for potential cure in pancreatic cancer. Patients admitted for resection may have the procedure deferred during their hospitalization. We aim to identify factors that lead pancreatic cancer patients to undergo resection. Methods: An analysis utilizing the Nationwide Inpatient Sample (NIS) database, 2003-2009. Study population included adults (>= 18 years) with pancreatic cancer who underwent either pancreatic resection or other interventions. Surgeon volume classified based on the median into low and high-volume surgeon. Results: Eleven thousand three hundred and sixty-five patients were included; 68.0% underwent pancreatic resection, while 32.0% had other interventions. The majority of patients resected were <60 years old, female, with higher annual household income (P<0.05 for all). Patients with Medicaid coverage and comorbidity scores >= 2 were least likely to undergo pancreatic resection. Resection was more likely for high-volume surgeons, high-volume hospitals and teaching hospitals (P<0.05 for all). Those managed by high-volume surgeons were at a lower risk of postoperative complications, lower mortality, shorter hospital stay, and lower healthcare costs (P<0.05 for all). Conclusions: Patients' insurance type and economic status are significantly associated with their ability to achieve pancreatic resection. Surgeon experience and hospital volumes were also significantly associated with pancreatic resection, clinical and economic outcomes.
Life Sciences & Biomedicine Science & Technology Surgery

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