Effect of centralization and regionalization of pancreatic surgery on resection rates and survival

Abstract Background Centralization of pancreatic surgery in the Netherlands has been ongoing since 2011. The aim this study was to assess how centralization affected likelihood resection and survival patients with non-metastatic head periampullary cancer, diagnosed hospitals without services. Methods An observational cohort performed on nationwide data from Cancer Registry (2009–2017), including or cancer. period diagnosis divided into three time intervals: 2009–2011, 2012–2014 2015–2017. Hospital classified as a non-pancreatic centre. Analyses were using multivariable logistic Cox regression models. Results In total, 10 079 included, whom 3114 (30.9 per cent) centres. Between 2009–2011 2015–2017, number undergoing increased 1267 3169 (40.0 1705 3566 (47.8 (P for trend < 0.001). analysis, unlike previous periods, centres had similar (odds ratio 1.08, 95 cent c.i. 0.90 1.28; P = 0.422). period, however, overall higher than those (hazard 0.92, 0.85 0.99; 0.047). Conclusion After surgery, rate cancer became that Overall remained