Association Between Fragmentation of Care and Delivery of Adjuvant Chemotherapy in Patients Traveling to High-Volume Hospitals for Pancreatic Adenocarcinoma.

ABSTRACT:

Background

Surgical care for pancreatic ductal adenocarcinoma (PDAC) is increasingly centralized to high-volume hospitals (HVHs), prompting many patients to travel farther for resection. While surgery is centralized, adjuvant chemotherapy is often delivered locally, resulting in care fragmentation. The implications of this separation on chemotherapy receipt and survival are unclear. This study evaluated associations between travel distance, care fragmentation, and receipt of adjuvant chemotherapy in patients undergoing upfront PDAC resection at HVHs and assessed how these factors influenced overall survival.

Methods

Patients with non-metastatic PDAC who underwent upfront resection at HVHs (≥20 pancreatectomies/year) were identified from the National Cancer Database (2007-202

SUBMITTER: Hughes AJ 

PROVIDER: S-EPMC12765744 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature