COMMENTARY

More Patients With Pancreatic Cancer Should Be Given a Chance With Surgery

Albert B. Lowenfels, MD

Disclosures

October 22, 2007

Perioperative Mortality for Pancreatectomy: A National Perspective

McPhee JT, Hill JS. Whalen GF, et al.
Ann Surg 2007; 246: 246-253

To determine the trend in operative mortality after pancreatectomy, the authors reviewed data from nearly 280,000 patients operated in the United States during 1998-2003. Only 14% of patients (n = 39,463) underwent pancreatic resection during the study period, with an overall mortality of 5.9 %. During the study period, hospital mortality rates decreased significantly from 7.8% at the start to 4.6% in 2003 (P = .0001). The number of patients treated in low-, medium-, or high-volume centers was about equal, but there was a significant difference in mortality: 9.2% mortality in low volume hospitals (less than 5 cases per year) compared to 2.4% in high volume centers (more than 18 cases per year).

Most reports of mortality after pancreatectomy come from single centers, rather than from a large national dataset, as reported here. It is discouraging that only 14% of all patients were deemed to be suitable candidates for surgical resection -- in marked contrast to resectability rates for cancers at other common sites. As in other reports, centers seeing larger volumes of patients with pancreatic cancer had lower operative mortality rates than centers managing fewer cases.

Abstract

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