ArticleJournal of surgical oncology2022
Impact of care fragmentation on the outcomes of patients receiving neoadjuvant and adjuvant therapy for pancreatic adenocarcinoma.
Article in Journal of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Failure to Undergo Resection Following Neoadjuvant Therapy for Resectable Pancreatic Cancer: A Secondary Analysis of SWOG S1505.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Trial
- Association Between Fragmentation of Care and Delivery of Adjuvant Chemotherapy in Patients Traveling to High-Volume Hospitals for Pancreatic Adenocarcinoma.Annals of surgical oncology · 2026Article
- Fragmented but not necessarily flawed.American journal of surgery · 2025Article
- Role of Neoadjuvant Therapy for Patients with Adenosquamous Carcinoma of the Pancreas: Outcomes from the National Cancer Database.Journal of gastrointestinal cancer · 2025Article
- Fragmented Care and Guideline-Concordant Treatment in Locally Advanced Cervical Cancer.Obstetrics and gynecology · 2025Article
- Fragmentation of care in breast cancer: greater than the sum of its parts.Breast cancer research and treatment · 2024Article
- ASO Author Reflections: Fragmented Care in Patients with Peritoneal Metastases.Annals of surgical oncology · 2024Article
- Fragmentation of Care in Patients with Peritoneal Metastases Undergoing Cytoreductive Surgery.Annals of surgical oncology · 2024Article
- Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan.Journal of general and family medicine · 2023Article
- Nationwide changes in radiation oncology travel and location of care before and during the COVID-19 pandemic.Radiation oncology journal · 2023Article
- Multi-institutional Care in Clinical Stage II and III Esophageal Cancer.The Annals of thoracic surgery · 2023Article
- Fragmentation of Care in Pancreatic Cancer: Effects on Receipt of Care and Survival.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Multi-specialty physician perspectives on barriers and facilitators to the use of neoadjuvant therapy for pancreatic ductal adenocarcinoma.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
introductionNeoadjuvant therapy (NT) is increasingly used for localized pancreatic ductal adenocarcinoma (PDAC). The impact of care fragmentation during NT on the outcomes of patients with PDAC is unknown.
methodsAdult patients with Stage I-III PDAC who received NT and patients who underwent surgery first followed by adjuvant therapy (AT) between 2004 and 2016 were queried from the National Cancer Database. Short- and long-term outcomes were compared between patients who received fragmented care (FC; care provided at >1 hospital) versus integrated care (IC; care at a single institution).
resultsAmong 6522 patients who underwent NT before pancreatectomy, 3755 (57.6%) received FC and 2767 (42.4%) received IC. While patients who received FC had a longer time to initiation of treatment (33.2 vs. 29.7 days, p < 0.001), there was no difference in median overall survival (OS) (26.7 vs. 26.5 months, p = 0.6). Among patients who underwent upfront surgery followed by AT (n = 15 291), patients who received FC had a longer time from diagnosis to undergoing surgery but less time from surgery to AT and no difference in OS (24.0 vs. 24.0 months, p = 0.910).
conclusionAlthough care fragmentation was associated with slightly longer times to initiate and complete treatment among patients with localized PDAC, long-term survival outcomes were similar.
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