Proclivity to Explore Locally Advanced Pancreas Cancer Is Not Associated with Surgeon Volume

Published on May 23, 2021in Journal of Gastrointestinal Surgery2.573
· DOI :10.1007/S11605-021-05034-W
Alex B. Blair17
Estimated H-index: 17
(Johns Hopkins University),
Robert W. Krell17
Estimated H-index: 17
+ 9 AuthorsBradley N. Reames3
Estimated H-index: 3
(UNMC: University of Nebraska Medical Center)
BACKGROUND AND PURPOSE There is limited high-level evidence to guide locally advanced pancreas cancer (LAPC) management. Recent work shows that surgeons' preferences in LAPC management vary broadly. We sought to examine whether surgeon volume was associated with attitudes regarding LAPC management. METHODS An electronic survey was distributed by email to an international cohort of pancreas surgeons to evaluate practice patterns regarding LAPC management. Clinical vignette-based questions evaluated surgeons' attitudes regarding patient eligibility and the proclivity to offer exploration. Surgeons were classified into "low-" or "high-volume" categories according to thresholds of self-reported annual pancreatectomy volume. Surgeon's attitudes regarding LAPC management and inclination to consider exploration were compared across annual volume categories. RESULTS A total of 153 eligible responses were received from 4 continents, for an estimated response rate of 10.6%. Median duration of practice was 12 years (IQR 6-20). Most respondents reported >25 cases/year (89, 58.2%), of which 34 (22.2%) reported >50. Compared to surgeons with 25 cases/year practiced longer (median 15 vs. 7.5 years, P 50 cases/year were more likely to offer arterial resection (70.6% vs. 43.7%, P=0.006). The willingness to offer (or defer) exploration did not differ across any categories of surgeons' annual case volume. CONCLUSIONS In an international survey of pancreas surgeons, the proclivity to consider exploration for LAPC was not associated with multiple categories of surgeon volume. Better evidence is needed to define the optimal management approach to LAPC.
#1Bradley N. Reames (UNMC: University of Nebraska Medical Center)H-Index: 19
#1Bradley N. Reames (UNMC: University of Nebraska Medical Center)H-Index: 2
Last. Jin He (Johns Hopkins University)H-Index: 40
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