There is an extensive body of research in complex cancer surgery that asserts a volume-outcome association in which patients are safer and have improved survival when their surgery is performed at hospitals and by surgeons with higher volume experience.1,2 This volume-outcome relationship has been especially true after resection for pancreatic cancer.3 As a consequence, organizations have advocated for minimum-volume standards and, as such, a centralization of complex cancer surgery operations. However, concerns about decreasing access to complex cancer surgery have been raised.4 Given this concern, we modeled what an optimal location-allocation market for hospitals performing pancreatic resections would look like, with the goal of maximizing market share while minimizing cannibalization and eliminating low-volume centers.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Diaz A, Pawlik TM. Optimal Location for Centralization of Hospitals Performing Pancreas Resection in California. JAMA Surg. 2020;155(3):261–263. doi:10.1001/jamasurg.2019.4937
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: