Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database

Veronica G. Onete, Marc G. Besselink, Chanielle M. Salsbach, Casper H. Van Eijck, Olivier R. Busch, Dirk J. Gouma, Ignace H. De Hingh, Egbert Sieders, Cornelis H. Dejong, Johan G. Offerhaus, I. Quintus Molenaar

Research output: Contribution to journalArticle

Abstract

Background Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Methods Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. Results During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60% versus 54%, P = 0.035) although they operated on more advanced (T3/T4) tumours (72% versus 58%, P <0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2% in 2004 versus 17.5% in 2009, P <0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6% in 2004 versus 11% in 2009, P <0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25% versus 15%, P <0.001). Conclusions Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed.

Original languageEnglish (US)
Pages (from-to)736-742
Number of pages7
JournalHPB
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

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Pancreaticoduodenectomy
Databases
Pathology
Low-Volume Hospitals
Bile Ducts
High-Volume Hospitals
Neoplasms
Tumor Burden
Mortality

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Onete, V. G., Besselink, M. G., Salsbach, C. M., Van Eijck, C. H., Busch, O. R., Gouma, D. J., ... Molenaar, I. Q. (2015). Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database. HPB, 17(8), 736-742. https://doi.org/10.1111/hpb.12425

Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database. / Onete, Veronica G.; Besselink, Marc G.; Salsbach, Chanielle M.; Van Eijck, Casper H.; Busch, Olivier R.; Gouma, Dirk J.; De Hingh, Ignace H.; Sieders, Egbert; Dejong, Cornelis H.; Offerhaus, Johan G.; Molenaar, I. Quintus.

In: HPB, Vol. 17, No. 8, 01.08.2015, p. 736-742.

Research output: Contribution to journalArticle

Onete, VG, Besselink, MG, Salsbach, CM, Van Eijck, CH, Busch, OR, Gouma, DJ, De Hingh, IH, Sieders, E, Dejong, CH, Offerhaus, JG & Molenaar, IQ 2015, 'Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database', HPB, vol. 17, no. 8, pp. 736-742. https://doi.org/10.1111/hpb.12425
Onete VG, Besselink MG, Salsbach CM, Van Eijck CH, Busch OR, Gouma DJ et al. Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database. HPB. 2015 Aug 1;17(8):736-742. https://doi.org/10.1111/hpb.12425
Onete, Veronica G. ; Besselink, Marc G. ; Salsbach, Chanielle M. ; Van Eijck, Casper H. ; Busch, Olivier R. ; Gouma, Dirk J. ; De Hingh, Ignace H. ; Sieders, Egbert ; Dejong, Cornelis H. ; Offerhaus, Johan G. ; Molenaar, I. Quintus. / Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database. In: HPB. 2015 ; Vol. 17, No. 8. pp. 736-742.
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abstract = "Background Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Methods Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. Results During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60{\%} versus 54{\%}, P = 0.035) although they operated on more advanced (T3/T4) tumours (72{\%} versus 58{\%}, P <0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2{\%} in 2004 versus 17.5{\%} in 2009, P <0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6{\%} in 2004 versus 11{\%} in 2009, P <0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25{\%} versus 15{\%}, P <0.001). Conclusions Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed.",
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T1 - Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database

AU - Onete, Veronica G.

AU - Besselink, Marc G.

AU - Salsbach, Chanielle M.

AU - Van Eijck, Casper H.

AU - Busch, Olivier R.

AU - Gouma, Dirk J.

AU - De Hingh, Ignace H.

AU - Sieders, Egbert

AU - Dejong, Cornelis H.

AU - Offerhaus, Johan G.

AU - Molenaar, I. Quintus

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Methods Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. Results During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60% versus 54%, P = 0.035) although they operated on more advanced (T3/T4) tumours (72% versus 58%, P <0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2% in 2004 versus 17.5% in 2009, P <0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6% in 2004 versus 11% in 2009, P <0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25% versus 15%, P <0.001). Conclusions Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed.

AB - Background Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Methods Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. Results During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60% versus 54%, P = 0.035) although they operated on more advanced (T3/T4) tumours (72% versus 58%, P <0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2% in 2004 versus 17.5% in 2009, P <0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6% in 2004 versus 11% in 2009, P <0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25% versus 15%, P <0.001). Conclusions Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed.

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