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Defining value for pancreatic surgery in early-stage pancreatic cancer

JAMA Aug 28, 2019

Bateni SB, et al. - Via a retrospective analysis of 2,786 patients with stages I to II pancreatic adenocarcinoma who underwent pancreatic resection, researchers recognized patient and hospital features related to improved overall survival, reduced costs, and larger value among patients with pancreatic cancer who were undergoing curative resection. Postoperative chemotherapy and high-volume centers had a relation to greater overall survival. Higher Elixhauser comorbidity index scores, complications, readmissions, and longer lengths of stay were correlated with greater costs, whereas postoperative chemotherapy was related to lower costs. National Cancer Institute-designated and high-volume centers were not correlated with costs. However grades III and IV tumors, T3 category disease, complications, readmissions, and length of stay were inversely linked to high-value care, National Cancer Institute (NCI) designation and high-volume centers were not. Thus, high-value care was concluded to be related to significant patient features and postoperative outcomes. Nevertheless, NCI-designated and high-volume centers were not correlated with a higher value. Moreover, targeted measures to improve value may be required in these centers.
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