کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6250270 | 1611480 | 2016 | 8 صفحه PDF | دانلود رایگان |
BackgroundDurable clinical gains in surgical care are frequently reliant on well-developed standardization of practices. We hypothesized that the standardization of surgical management would result in improved long-term survival in pancreatic cancer.MethodsSeventy-seven consecutive, eligible patients representing all patients who underwent pancreaticoduodenectomy and received comprehensive, long-term postoperative care at the University of Florida were analyzed. Patients were divided into prestandardization and poststandardization groups based on the implementation of a pancreatic surgery partnership, or standardization program.ResultsStandardization resulted in a reduction in median length of stay (10 vs 12Â days; PÂ =Â .032), as well as significant gains in disease-free survival (17 vs 11Â months; P = .017) and overall survival (OS; 26 vs 16Â months; P = .004). The improvement in overall survival remained significant on multivariate analysis (hazard ratio = .46, P = .005).ConclusionsStandardization of surgical management of pancreatic cancer was associated with significant gains in long-term survival. These results suggest strongly that management of pancreatic head adenocarcinoma be standardized likely by regionalization of care at high performing oncologic surgery programs.
Journal: The American Journal of Surgery - Volume 212, Issue 2, August 2016, Pages 195-201.e1