ArticleAnnals of surgical oncology2026
Improved Survival with Delayed Surgery at High-Volume Centers Versus Early Surgery at Low-Volume Centers for Pancreatic Cancer.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Social Progress Index as a Determinant of Healthcare Access and Treatment in Pancreatic Cancer.Current oncology (Toronto, Ont.) · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the relationship between higher surgical volume and improved outcomes for pancreatic operations is well established, centralizing care to high-volume centers (HVC) may prolong the interval from diagnosis to surgery. This study sought to compare outcomes of patients who had longer wait times for upfront surgery for pancreatic cancer (PDAC) at HVCs with those of patients who underwent earlier surgery at low-volume centers (LVCs).
methodsPatients undergoing upfront pancreatic surgery for T1-3N0-2M0 PDAC were identified from the 2004-2023 National Cancer Database. High-volume centers were defined using Leapfrog criteria as centers performing ≥ 20 pancreatic resections/year, with others defined as LVCs. Patients who waited more than 28 days for resection at HVCs were classified as "long wait/high volume," whereas those who underwent surgery in ≤ 14 days at LVCs were classified as "short wait/low volume."
resultsAmong 15,310 patients meeting the inclusion criteria, 9598 (63%) were short wait/low volume and 5712 (37%) were long wait/high volume. In unadjusted analysis, long wait/high volume demonstrated superior 5-year survival (23% vs. 19%, P < 0.001, log-rank). After comprehensive risk adjustment, waiting for surgery at an HVC remained associated with reduced mortality hazard during 5 years of follow-up evaluation (hazard ratio [HR], 0.81; 95% CI, 0.77-0.85; P < 0.001). Considering acute endpoints, the long-wait/high-volume group demonstrated greater likelihood of complete (R0) resection and reduced 30-day mortality, but higher risk of nodal disease and upstaging at resection.
conclusionWaiting for surgery at an HVC is associated with improved acute outcomes and superior overall survival compared with earlier operations at an LVC. These findings assuage concerns regarding the potential longer wait times for surgery associated with centralization of surgical care for PDAC.
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