Evidence map›Paper›PMID 42542416›Full record

ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2026

Assessing the interplay of operative volume at the hospital and surgeon level for pancreatic cancer.

Dhruv J Patel, Joseph H Cotler, Bryan Palis, Anthony D Yang, C M Schmidt, Ronald J Weigel, Karl Y Bilimoria, Ryan J Ellis

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Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Dhruv J PatelAmerican College of Surgeons Cancer Programs, National Cancer Database, Chicago, IL, USA; Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Joseph H CotlerAmerican College of Surgeons Cancer Programs, National Cancer Database, Chicago, IL, USA.
Bryan PalisAmerican College of Surgeons Cancer Programs, National Cancer Database, Chicago, IL, USA.
Anthony D YangAmerican College of Surgeons Cancer Programs, National Cancer Database, Chicago, IL, USA; Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
C M SchmidtDepartment of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Ronald J WeigelAmerican College of Surgeons Cancer Programs, National Cancer Database, Chicago, IL, USA; Department of Surgery, University of Iowa, Iowa City, IA, USA.
Karl Y BilimoriaSurgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Ryan J EllisSurgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: ellisrj@iu.edu.

Funding

Surgical Oncology Research Training at Indiana (SORTI)T32CA282070 · NCI · INDIANA UNIVERSITY INDIANAPOLIS · PI KARL Y BILIMORIA, Harikrishna Nakshatri · 2024 to 2026
$1.5M
NCI NIH HHS T32 CA282070
6 · The paper itself

Abstract

backgroundThe current retrospective study aimed to assess the interaction between surgeon-volume and hospital-volume on outcomes after pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

methodsPatients with PDAC undergoing PD from 2008 to 2023 were identified using the National Cancer Database. Operative volumes of ≥20 cases/year defined high-volume hospitals (HVH) and ≥12 cases/year defined high-volume surgeons (HVS). Those below those thresholds were low-volume surgeons (LVS) and low-volume hospitals (LVH). Multivariable logistic regression was used to assess associations between surgeon/hospital volume and outcomes, relative to HVS/HVH.

resultsThe inclusion cohort consisted of 50,519 patients treated by 3155 surgeons operating at 976 hospitals. 90-day mortality declined with increasing volume: LVS/LVH = 6.4%, HVS/LVH = 5.7%, LVS/HVH = 4.0%, HVS/HVH = 3.5% (p < 0.001). Patients undergoing surgery by HVS/LVH [Odds Ratio (OR): 1.58, 95% Confidence Interval (95%CI) (1.12, 2.24), p = 0.009] and LVS/LVH [OR: 1.59, 95%CI (1.24, 2.04), p < 0.001] had a higher adjusted likelihood of mortality. LVS/HVH was not associated with mortality compared with HVS/HVH. Both HVS/LVH [OR: 1.93, 95%CI (1.27, 2.92), p = 0.002] and LVS/LVH [OR: 1.60, 95% CI (1.15, 2.23), p = 0.006] had a higher likelihood of readmission.

conclusionOutcomes after PD for PDAC remain more greatly influenced by hospital-volume rather than surgeon-volume.

Indexed as

Carcinoma, Pancreatic DuctalHospitals, High-VolumeHospitals, Low-VolumePancreatic NeoplasmsPancreaticoduodenectomySurgeonsAgedDatabases, FactualFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeUnited States

Identifiers

PMID42542416
PMCPMC13519407

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.