Outcome quality standards in pancreatic oncologic surgery

Ann Surg Oncol. 2014 Apr;21(4):1138-46. doi: 10.1245/s10434-013-3451-2. Epub 2014 Jan 6.

Abstract

Purpose: To identify quality indicators and establish acceptable quality limits (AQLs) in pancreatic oncologic surgery using a formal statistical methodology.

Methods: Indicators have been identified through systematic literature reviews and guidelines for pancreatic surgery. AQLs were determined for each indicator with confidence intervals of 99.8 and 95 % above and below the weighted average by sample size from the different series examined.

Results: Several indicators have been identified with the following results as AQLs: resectability rate >59 %; morbidity, mortality, and pancreatic fistula rate in pancreaticoduodenectomy <55, <5, and <16 %, respectively; morbidity, mortality, and fistula rate in distal pancreatectomy <53, <4, and <31 %, respectively; number of lymph nodes retrieved >15; R1 resection <46 %; survival at 1, 3, and 5 years >54, >19, and >8 %, respectively.

Conclusions: A series of different indicators for quality surgical care outcome in pancreatic cancer, as well as their limits, have been determined according to a standard methodology.

Publication types

  • Review

MeSH terms

  • Humans
  • Outcome Assessment, Health Care / standards*
  • Pancreatectomy*
  • Pancreatic Neoplasms / surgery*
  • Prognosis
  • Quality Assurance, Health Care / standards*