Viewpoints / Position Papers
Study Documents Significant Underuse of Surgical Resections
Pancreatectomy, the surgical removal of all or part of the pancreas, offers the best chance of long-term control of all types of pancreatic cancer. However, the use of surgery is significantly underused, even among eligible candidates, according to a published national study.*
Led by Karl Y. Bilimoria, MD, a surgeon at Northwestern University in Chicago, the research team analyzed data on 9,559 patients with “potentially resectable” early stage cancers of the pancreas treated between 1995 and 2004. The goal of the study was to evaluate the use of surgery and to find out why physicians chose not to use it as a treatment option in some case.
Surgery was not utilized as a treatment option in 71 percent of cases: the vast majority of the patients. Of these, close to 20 percent were considered too old, too ill or refused the operation. As many as 38 percent were not offered the surgical option, and no identifiable reason was cited for an additional 14 percent of the patients.
Patients treated at centers with a high average annual volume of pancreatic cancer cases and at academic institutions were more likely to undergo surgery than those at low volume centers and community hospitals. Surgical resections were significantly more likely at National Comprehensive Cancer Network hospitals and National Cancer Institute-designated cancer centers. This was most likely is due to clincians’ greater access to the latest diagnostic and surgical approaches, multidisciplinary support, and resources.
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*Bilimoria, KY, et. al., National Failure to Operate on Early Stage Pancreatic Cancer, Annals of Surgery 2007;246,2:173-180.
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