Average treatment effect of facility hepatopancreatobiliary cancer volume on survival of non-resected pancreatic adenocarcinoma.
Publication/Presentation Date
11-1-2022
Abstract
BACKGROUND: To examine the average treatment effect of hepato-pancreato-biliary (HPB) cancer volume on survival outcomes of patients with non-resected pancreatic adenocarcinoma (PDAC).
METHODS: We queried the National Cancer Database (2004-2018) for patients with HPB malignancies (PDAC, pancreatic neuroendocrine neoplasms, hepatocellular carcinoma, biliary tract cancers). We determined the 25th, 50th, and 75th percentiles based on the total annual HPB volume. We then identified patients with non-resected PDAC. We utilized inverse probability (IP)-weighted Cox regression to estimate the effect of facility volume on overall survival (OS).
RESULTS: We identified 710,988 patients with HPB malignancies. The 25th, 50th, and 75th percentiles of total annual HPB volume were 32, 71, and 177 cases/year, respectively. We included a total of 196,150 patients with non-resected PDAC. Patients treated at ≥25th, ≥50th, and ≥75th percentile facilities had improved median OS compared to those treated at facilities below these thresholds (5.8 vs. 4.2months, 6.5 vs. 4.5months, 7.5 vs. 4.8months, respectively; p < 0.001 for all). Treatment at facilities ≥25th, ≥50th, and ≥75th percentile resulted in lower hazards of death than treatment at lower-percentile facilities (HR: 0.87, 95% CI: 0.84-0.90; HR: 0.87, 95% CI: 0.83-0.91; HR: 0.85, 95% CI: 0.79-0.91, respectively).
CONCLUSION: Our data suggest that consolidation of care of patients with PDAC to high-volume centers may be beneficial even in the nonoperative setting.
Volume
24
Issue
11
First Page
1878
Last Page
1887
ISSN
1477-2574
Published In/Presented At
Elshami, M., Ahmed, F. A., Kakish, H., Hue, J. J., Hoehn, R. S., Rothermel, L. D., Bajor, D., Mohamed, A., Selfridge, J. E., Ammori, J. B., Hardacre, J. M., Winter, J. M., & Ocuin, L. M. (2022). Average treatment effect of facility hepatopancreatobiliary cancer volume on survival of non-resected pancreatic adenocarcinoma. HPB : the official journal of the International Hepato Pancreato Biliary Association, 24(11), 1878–1887. https://doi.org/10.1016/j.hpb.2022.07.007
Disciplines
Medicine and Health Sciences
PubMedID
35961931
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article
