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. 2022 Feb;26(2):367-375.
doi: 10.1007/s11605-020-04612-8. Epub 2021 Sep 10.

The Impact of a Centralised Pancreatic Cancer Service: a Case Study of Wales, UK

Nicholas G Mowbray  1   2 , Rowena Griffiths  3   4 , Ashley Akbari  3   4 , Hayley Hutchings  3 , Gareth Jenkins  3 , Bilal Al-Sarireh  3   5
Affiliations

The Impact of a Centralised Pancreatic Cancer Service: a Case Study of Wales, UK

Nicholas G Mowbray et al. J Gastrointest Surg. 2022 Feb.

Abstract

Introduction: The centralisation of pancreatic cancer (PC) services still varies worldwide. This study aimed to assess the impact that a centralisation has had on patients in South Wales, UK.

Methods: A retrospective cohort analysis of patients in South Wales, UK, with PC prior to (2004-2009), and after (2010-2014) the formation of a specialist centre. Patients were identified using record linkage of electronic health records.

Results: The overall survival (OS) of all 3413 patients with PC increased from a median (IQR) 10 weeks (3-31) to 11 weeks (4-35), p = 0.038, after centralisation. The OS of patients undergoing surgical resection or chemotherapy alone did not improve (93 weeks (39-203) vs. 90 weeks (50-95), p = 0.764 and 33 weeks (20-57) vs. 33 weeks (19-58), p = 0.793). Surgical resection and chemotherapy rates increased (6.1% vs. 9.2%, p < 0.001 and 19.7% vs. 27.0%, p < 0.001). The 30-day mortality rate trended downwards (7.2% vs. 3.6%, p = 0.186). The percentage of patients who received no treatment reduced (75.2% vs. 69.6%, p < 0.001).

Conclusion: The centralisation of PC services in South Wales is associated with a small increase in OS and a larger increase in PC treatment utilisation. It is concerning that many patients still fail to receive any treatments.

Keywords: Centralisation; Pancreatic cancer; Pancreatic surgery.

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