Variation in survival after surgery for peri-ampullary cancer in a regional cancer network

Amr, B, Shahtahmassebi, G ORCID: https://orcid.org/0000-0002-0630-2750, Aroori, S, Bowles, MJ, Briggs, CD and Stell, DA, 2017. Variation in survival after surgery for peri-ampullary cancer in a regional cancer network. BMC Surgery, 17, p. 23. ISSN 1471-2482

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Abstract

Background: Centralisation of specialist surgical services requires that patients are referred to a regional centre for surgery. This process may disadvantage patients who live far from the regional centre or are referred from other hospitals by making referral less likely and by delaying treatment, thereby allowing tumour progression. The aim of this study is to explore the outcome of surgery for peri-ampullary cancer (PC) with respect to referring hospital and travel distance for treatment within a network served by five hospitals. Methods: Review of a unit database was undertaken of patients undergoing surgery for PC between January 2006 and May 2014. Results: 394 patients were studied. Although both the median travel distance for patients from the five hospitals (10.8, 86, 78.8, 54.7 and 89.2 km) (p < 0.05), and the annual operation rate for PC (2.99, 3.29, 2.13, 3.32 and 3.07 per 100,000) (p = 0.044) were significantly different, no correlation was noted between patient travel distance and population operation rate at each hospital. No difference was noted between patients from each hospital in terms of resection completion rate or pathological stage of the resected tumours. The median survival after diagnosis for patients referred from different hospitals ranged from 1.2 to 1.7 years and regression analysis revealed that increased travel distance to the regional centre was associated with a small survival advantage. Conclusion: Although variation in the provision and outcome of surgery for PC between regional hospitals is noted, this is not adversely affected by geographical isolation from the regional centre.

Item Type:	Journal article
Publication Title:	BMC Surgery
Creators:	Amr, B., Shahtahmassebi, G., Aroori, S., Bowles, M.J., Briggs, C.D. and Stell, D.A.
Publisher:	BioMed Central
Date:	7 March 2017
Volume:	17
ISSN:	1471-2482
Identifiers:	Number Type 10.1186/s12893-017-0220-3 DOI 220 Publisher Item Identifier
Rights:	© The Author(s) 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)
Divisions:	Schools > School of Science and Technology
Record created by:	Jonathan Gallacher
Date Added:	12 Apr 2017 08:17
Last Modified:	09 Jun 2017 14:14
URI:	https://irep.ntu.ac.uk/id/eprint/30504

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