dc.contributor.author | Narendra, A | |
dc.contributor.author | Baade, PD | |
dc.contributor.author | Aitken, JF | |
dc.contributor.author | Fawcett, J | |
dc.contributor.author | Smithers, BM | |
dc.date.accessioned | 2020-01-14T04:47:27Z | |
dc.date.available | 2020-01-14T04:47:27Z | |
dc.date.issued | 2019 | |
dc.identifier.issn | 1365-182X | |
dc.identifier.doi | 10.1016/j.hpb.2019.11.015 | |
dc.identifier.uri | http://hdl.handle.net/10072/390143 | |
dc.description.abstract | Background: An association between higher hospital-volume and better “quality of surgery” and long-term survival has not been reported following pancreatic cancer surgery in low resection-volume regions such as in Australia. Using a population-level study, we compare “quality of surgery” and two-year survival following pancreaticoduodenectomy between Australian hospitals grouped by resection-volume.
Methods: Data on all patients undergoing pancreaticoduodenectomy for adenocarcinoma in the Australian state of Queensland, between 2001 and 2015, were obtained from the Queensland Oncology Repository. Hospitals were grouped into high (≥6 resections annually) and low (<6) volume centres. Following adjustment for case-mix, “quality-of-treatment” indicators were compared between hospital groups using multivariate logistic regression and Poisson regression analysis; and two-year cancer-specific and overall survival were compared using multivariate Cox proportional hazard models.
Results: Compared with high-volume centres, low-volume centres had worse two-year cancer-specific survival (Adjusted HR = 1.31; 95% CI:1.03–1.68), higher 30-day mortality (Adjusted IRR = 3.81; 95% CI: 1.36–10.62) and fewer patients received “high-quality surgery” (Adjusted OR = 0.55; 95% CI: 0.33–0.90). Differences in 30-day mortality, or “quality-of-treatment” indicators did not entirely explain the observed survival difference between hospital-volume groups.
Conclusion: In an Australian environment, a “high” hospital-volume was significantly associated with better quality surgery and two-year survival following pancreaticoduodenectomy. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Elsevier | |
dc.publisher.place | United Kingdom | |
dc.relation.ispartofjournal | HPB | |
dc.subject.fieldofresearch | Clinical sciences | |
dc.subject.fieldofresearchcode | 3202 | |
dc.title | Pancreaticoduodenectomy in a low-resection volume region: a population-level study examining the impact of hospital-volume on surgical quality and longer-term survival | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dcterms.bibliographicCitation | Narendra, A; Baade, PD; Aitken, JF; Fawcett, J; Smithers, BM, Pancreaticoduodenectomy in a low-resection volume region: a population-level study examining the impact of hospital-volume on surgical quality and longer-term survival, HPB, 2019 | |
dcterms.license | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.date.updated | 2020-01-13T01:10:33Z | |
dc.description.version | Version of Record (VoR) | |
gro.description.notepublic | This publication has been entered into Griffith Research Online as an Advanced Online Version. | |
gro.rights.copyright | © 2019 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. | |
gro.hasfulltext | Full Text | |
gro.griffith.author | Baade, Peter D. | |
gro.griffith.author | Aitken, Joanne | |