University of California, San Francisco - East Bay Surgery, Highland Hospital, 1411 E 31st St, Q1C 22134, Oakland, CA, 94602, USA; Department of Surgery, Kaiser Permanente-Oakland Medical Center, 3600 Broadway, Oakland, CA, 94611, USA.
University of California, San Francisco - East Bay Surgery, Highland Hospital, 1411 E 31st St, Q1C 22134, Oakland, CA, 94602, USA; Department of Surgery, Kaiser Permanente-Oakland Medical Center, 3600 Broadway, Oakland, CA, 94611, USA.
Am J Surg. 2022 Jun;223(6):1035-1039. doi: 10.1016/j.amjsurg.2021.09.036. Epub 2021 Oct 1.
BACKGROUND: Higher-volume centers for pancreatic cancer surgeries have been shown to have improved outcomes such as length of stay. We examined how centralization of pancreatic cancer care within a regional integrated healthcare system improves overall survival. METHODS: We conducted a retrospective study of 1621 patients treated for pancreatic cancer from February 2010 to December 2018. Care was consolidated into 4 Centers of Excellence (COE) in surgery, medical oncology, and other specialties. Descriptive statistics, bivariate analysis, Chi-square tests, and Kaplan-Meier analysis were performed. RESULTS: Neoadjuvant chemotherapy use rose from 10% to 31% (p < .001). The median overall survival (OS) improved by 3 months after centralization (p < .001), but this did not reach significance on multivariate analysis. CONCLUSIONS: Our results suggest that in a large integrated healthcare system, centralization improves overall survival and neoadjuvant therapy utilization for pancreatic cancer patients.
背景：更高容量的胰腺癌手术中心已显示出改善了住院时间等结果。我们研究了在区域综合医疗保健系统内集中胰腺癌治疗如何提高整体生存率。
方法：我们对 2010 年 2 月至 2018 年 12 月期间接受胰腺癌治疗的 1621 名患者进行了回顾性研究。治疗集中到 4 个卓越中心（COE），包括手术、肿瘤内科和其他专业。进行了描述性统计、双变量分析、卡方检验和 Kaplan-Meier 分析。
结果：新辅助化疗的使用率从 10%上升到 31%（p<0.001）。集中治疗后，中位总生存期（OS）提高了 3 个月（p<0.001），但多变量分析未达到显著性。
结论：我们的结果表明，在大型综合医疗保健系统中，集中治疗可提高胰腺癌患者的整体生存率和新辅助治疗的利用率。
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