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dc.contributor.authorNarendra, A
dc.contributor.authorBaade, PD
dc.contributor.authorAitken, JF
dc.contributor.authorFawcett, J
dc.contributor.authorSmithers, BM
dc.date.accessioned2020-01-14T04:47:27Z
dc.date.available2020-01-14T04:47:27Z
dc.date.issued2019
dc.identifier.issn1365-182X
dc.identifier.doi10.1016/j.hpb.2019.11.015
dc.identifier.urihttp://hdl.handle.net/10072/390143
dc.description.abstractBackground: 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.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.publisher.placeUnited Kingdom
dc.relation.ispartofjournalHPB
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.titlePancreaticoduodenectomy in a low-resection volume region: a population-level study examining the impact of hospital-volume on surgical quality and longer-term survival
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationNarendra, 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.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated2020-01-13T01:10:33Z
dc.description.versionVersion of Record (VoR)
gro.description.notepublicThis 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.hasfulltextFull Text
gro.griffith.authorBaade, Peter D.
gro.griffith.authorAitken, Joanne


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