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International Journal of Surgical Oncology
Volume 2011 (2011), Article ID 936516, 8 pages
http://dx.doi.org/10.1155/2011/936516
Review Article

Treatment of Pancreatic and Periampullary Cancers at a Community Hospital: Successful Application of Tertiary Care Treatment Standards

1Department of Surgery, McKay-Dee Hospital Center, Ogden Regional Medical Center, Ogden, UT 84405, USA
2Department of Surgery, Medical Oncology, Ogden Regional Medical Center, Ogden, UT 84405, USA
3Department of Surgery, University of Utah, Salt Lake City, UT 84132, USA
4Department of Medical Oncology, McKay-Dee Hospital Center, Ogden Regional Medical Center, Ogden, UT 84405, USA
5Department of Radiation Oncology, McKay-Dee Hospital Center, Ogden, UT 84403, USA
6Department of Radiation Oncology, Ogden Regional Medical Center, Ogden, UT 84405, USA
7Department of Medical Oncology, Chairman of Cancer Committee, McKay-Dee Hospital Center, Ogden, UT 84405, USA

Received 28 May 2011; Accepted 21 September 2011

Academic Editor: C. H. Yip

Copyright © 2011 Robert C. Moesinger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The treatment of pancreatic cancer and other periampullary neoplasms is complex and challenging. Major high-volume cancer centers can provide excellent multidisciplinary care of these patients but almost two-thirds of pancreatic cancer patients are treated at low volume centers. There is very little published data from low volume community cancer programs in regards to the treatment of periampullary cancer. In this study, a review of comprehensive periampullary cancer care at two low volume hospitals with comparison to national standards is presented. Methods. This is a retrospective review of 70 consecutive patients with periampullary neoplasms who underwent surgery over a 5-year period (2006–2010) at two community hospitals. Results. There were 51 successful resections of 70 explorations (73%) including 34 Whipple procedures. Mortality rate was 2.9%. Comparison of these patients to national standards was made in terms of operative mortality, resectability rate, administration of adjuvant therapy, clinical trial participation and overall survival. The results in these patients were comparable to national standards. Conclusions. With adequate commitment of resources and experienced surgical and oncologic practitioners, community cancer centers can meet national tertiary care standards in terms of pancreatic and periampullary cancer care.