دورية أكاديمية
Pancreatic Neuroendocrine Tumor: Rationale for Centralization in an Integrated Health Care System.
| العنوان: | Pancreatic Neuroendocrine Tumor: Rationale for Centralization in an Integrated Health Care System. |
|---|---|
| المؤلفون: | Kwak HV; From the Department of Surgery, University of California San Francisco-East Bay, Oakland, CA., Hsu DS; From the Department of Surgery, University of California San Francisco-East Bay, Oakland, CA., Le ST; From the Department of Surgery, University of California San Francisco-East Bay, Oakland, CA., Chang AL; University of California Davis, Davis, CA., Spitzer AL; Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA., Kazantsev GB; Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA., Peng PD; Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA., Chang CK; Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA. |
| المصدر: | Pancreas [Pancreas] 2022 Nov-Dec 01; Vol. 51 (10), pp. 1332-1336. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8608542 Publication Model: Print Cited Medium: Internet ISSN: 1536-4828 (Electronic) Linking ISSN: 08853177 NLM ISO Abbreviation: Pancreas Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: [New York, N.Y.] : Raven Press, [c1986- |
| مواضيع طبية MeSH: | Neuroendocrine Tumors*/surgery , Pancreatic Neoplasms*/surgery , Delivery of Health Care, Integrated*, Humans ; Survival Analysis ; Retrospective Studies ; Survival Rate |
| مستخلص: | Objectives: Given the complex surgical management and infrequency of pancreatic neuroendocrine tumor, we hypothesized that treatment at a center of excellence improves survival. Methods: Retrospective review identified 354 patients with pancreatic neuroendocrine tumor treated between 2010 and 2018. Four hepatopancreatobiliary centers of excellence were created from 21 hospitals throughout Northern California. Univariate and multivariate analyses were performed. The χ2 test of clinicopathologic factors determined which were predictive for overall survival (OS). Results: Localized disease was seen in 51% of patients, and metastatic disease was seen in 32% of patients with mean OS of 93 and 37 months, respectively (P < 0.001). On multivariate survival analysis, stage, tumor location, and surgical resection were significant for OS (P < 0.001). All stage OS for patients treated at designated centers was 80 and 60 months for noncenters (P < 0.001). Surgery was more common across stages at the centers of excellence versus noncenters at 70% and 40%, respectively (P < 0.001). Conclusions: Pancreatic neuroendocrine tumors are indolent but have malignant potential at any size with management often requiring complex surgeries. We showed survival was improved for patients treated at a center of excellence, where surgery was more frequently utilized. Competing Interests: The authors declare no conflict of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.) |
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| تواريخ الأحداث: | Date Created: 20230426 Date Completed: 20230428 Latest Revision: 20230501 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1097/MPA.0000000000002194 |
| PMID: | 37099775 |
| قاعدة البيانات: | MEDLINE |
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