ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2016
Overuse of surgery in patients with pancreatic cancer. A nationwide analysis in Italy.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Overuse in surgery by deviation from the "Choosing Wisely" campaign recommendations: a surrogate of unnecessary surgery and low-value care.Patient safety in surgery · 2026Article
- Live and learn: unexpected benign disease after pancreaticoduodenectomy for presumed malignancy.Updates in surgery · 2026Article
- [Patient safety in palliative surgery].Chirurgie (Heidelberg, Germany) · 2025Review
- The Italian registry of families at risk for pancreatic cancer (IRFARPC): implementation and evolution of a national program for pancreatic cancer surveillance in high-risk individuals.Familial cancer · 2024Review
- Impact of a non-therapeutic laparotomy in patients with locally advanced pancreatic cancer treated with induction (m)FOLFIRINOX: Trans-Atlantic Pancreatic Surgery (TAPS) Consortium study.The British journal of surgery · 2024Article
- Fast-track anesthesia and outcomes in hepatopancreatic cancer surgery: a retrospective analysis.Journal of anesthesia, analgesia and critical care · 2024Article
- Review
- Outcomes and risks in palliative pancreatic surgery: an analysis of the German StuDoQ|Pancreas registry.BMC surgery · 2022Article
- Systematic review of the predictors of health service use in pancreatic cancer.American journal of cancer research · 2022Review
- Total pancreatectomy as alternative to pancreatico-jejunal anastomosis in patients with high fistula risk score: the choice of the fearful or of the wise?Langenbeck's archives of surgery · 2021Observational
- Impact of time interval between multidisciplinary team meeting and intended pancreatoduodenectomy on oncological outcomes.BJS open · 2020Article
- Review
- Pancreatic fistula after pancreaticoduodenectomy-does surgical technique matter?Annals of translational medicine · 2020Article
- Diagnostic and therapeutic recommendations in pancreatic ductal adenocarcinoma. Recommendations of the Working Group of the Polish Pancreatic Club.Przeglad gastroenterologiczny · 2019Article
- Trends in treatment and survival of patients with nonresected, nonmetastatic pancreatic cancer: A population-based study.Cancer medicine · 2018Article
- Recent Advances in Pancreatic Cancer Surgery.Current treatment options in gastroenterology · 2017Review
- A rare case of esophageal metastasis from pancreatic ductal adenocarcinoma: a case report and literature review.Oncotarget · 2017Article
- Indications, technique, and results of robotic pancreatoduodenectomy.Updates in surgery · 2016Article
- Surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it : A proposal for esophageal, hepatic, pancreatic and colo-rectal surgery.Updates in surgery · 2016Article
- Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients.BioMed research international · 2016Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAccording to current guidelines, pancreatic cancer patients should be strictly selected for surgery, either palliative or resective.
methodsPopulation-based study, including all patients undergoing surgery for pancreatic cancer in Italy between 2010 and 2012. Hospitals were divided into five volume groups (quintiles), to search for differences among volume categories.
resultsThere were 544 hospitals performing 10 936 pancreatic cancer operations. The probability of undergoing palliative/explorative surgery was inversely related to volume, being 24.4% in very high-volume hospitals and 62.5% in very low-volume centres (adjusted OR 5.175). Contrarily, the resection rate in patients without metastases decreased from 86.9% to 46.1% (adjusted OR 7.429). As for resections, the mortality of non-resective surgery was inversely related to volume (p < 0.001). Surprisingly, mortality of non-resective surgery was higher than that for resections (8.2% vs. 6.7%; p < 0.01). Approximately 9% of all resections were performed on patients with distant metastases, irrespective of hospital volume group. The excess cost for the National Health System from surgery overuse was estimated at 12.5 million euro. DISCUSSION: Discrepancies between guidelines on pancreatic cancer treatment and surgical practice were observed. An overuse of surgery was detected, with serious clinical and economic consequences.
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