ArticleAnnals of surgical oncology2025
Variations in Outcomes of Surgical Oncology Fellowship Graduates Performing Hepatopancreatic Surgery in the United States Based on Fellowship Training Program.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- A laddered training model for breast surgery specialists: development and validation of a CBME-based precision education framework.BMC medical education · 2026Trial
- ASO Author Reflections: Complex General Surgical Oncology Fellowship Training: Variation in Outcomes of Graduates Performing Hepatopancreatic Surgery by Graduating Fellowship Program.Annals of surgical oncology · 2025Article
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Authors and funding
7 authors.
Funding
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Abstract
backgroundExposure in hepatopancreatic (HP) surgery can vary among Complex General Surgical Oncology (CGSO) fellowship graduates. Real-world outcomes of fellowship graduates performing HP surgery have not been previously examined.
methodsMedicare beneficiaries undergoing HP surgery for cancer between 2016 and 2021 were identified. Surgeon-level data, including fellowship training information, were linked to patient-level Medicare data. Trends and variations in severe complications and 90-day mortality according to fellowship training were examined.
resultsOverall, 9954 HP cancer operations (pancreatectomy: 7,566, 76%; hepatectomy: 2,388, 24%) were performed between 2016 and 2021. A total of 609 CGSO fellowship graduates trained at 42 different CGSO programs in the United States or Canada were identified. Most cases (93.2%) were performed by surgeons who had completed an ACGME-accredited CGSO program. Almost half of HP operations were performed by graduates of two specific CGSO programs (n = 4,769, 47.9%), whereas 92.1% (n = 9,166) of HP operations were performed by graduates of 15 CGSO programs. After adjusting for relevant, multilevel characteristics, marked variations in outcomes by CGSO fellowship program were noted following both hepatectomy and pancreatectomy. The adjusted probability of serious complications decreased from 2016 to 2021 (16.4% vs. 12.9%; p < 0.05), however, the likelihood of 90-day mortality remained relatively stable during the study period (2016: 6.4% vs. 2021: 5.3%; p = 0.19).
conclusionsWhile outcomes of CGSO graduates improved over time, a marked variation in outcomes of graduates performing HP surgery was noted based on their fellowship training. Further efforts should be made to enhance and standardize HP surgery exposure and training in CGSO programs for fellows intending to perform HP surgery in practice.
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