Zhi Ven Fong, David Chang, Carlos Fernandez-del Castillo, Cristina Ferrone, Ginger Jin, Angela Tramontano, Chin Hur, Andrew Warshaw, Keith Lillemoe Motaz Qadan
Background: Cancer center-accreditation is designed to identify centers that provide high-quality cancer care. We sought to examine if accreditation is associated with long-term oncologic outcomes.
Methods: Using the SEER-Medicare database, we identified patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1996–2013. Hospitals were categorized into three groups: Commission on Cancer-accredited (CoC) centers, National Cancer Institute-designated (NCI) centers, and “non-accredited” (NA) centers. Adjusted examined lymph nodes, disease-specific survival (DSS), and overall survival (OS) were calculated.
Results: We identified 5,118 patients who underwent pancreatectomy at 632 hospitals (41.0% NA, 49.6% CoC, 9.4% NCI). NCI had a higher median number of lymph nodes examined compared with CoC or NA centers (14 vs. 10 vs. 11.0 nodes, respectively; P<0.001). Patients treated at NCI centers had a higher 5-year DSS compared to those treated at CoC or NA centers (31.2% vs. 23.6% vs. 23.0%, respectively; P<0.001). Finally, patients treated at NCI centers had a higher 5-year OS compared to those treated at CoC or NA centers (23.5% vs. 18.9% vs. 17.9%, respectively; P<0.001). The associations held true when adjusted analysis was performed.
Conclusions: Patients with resected pancreatic cancer at NCI-designated centers are associated with higher number of lymph nodes examined, as well as improved OS and DSS. This effect was not observed with CoC-accredited centers. Further research is needed to elucidate the relationship between cancer center-accreditation and oncologic outcomes.
