Journal of surgical oncology
September 9, 2026 · via Europe PMC
Impact of Institutional Radiotherapy Patient Volume on Postoperative and Oncologic Outcomes After Neoadjuvant Radiation for Pancreatic Cancer.
Pannekoek A, Narayan RR, Carlson A, Ruan M, van Dams R, Chawla A, Molina G.
AI summary — for doctors, generated from the abstract only
In a large national database study, pancreatic cancer patients who received neoadjuvant radiation at lower-volume hospitals (for either pancreatic or esophageal/rectal cancer radiotherapy) had worse overall survival than those treated at higher-volume centers.
What was studied
A retrospective study using the National Cancer Database (2011-2019) of 2879 patients with pancreatic ductal adenocarcinoma (PDAC) who received neoadjuvant radiation therapy (NRT) followed by surgical resection, examining whether hospital-level NRT volume (defined by annual PDAC volume or by esophageal/rectal cancer NRT volume) was associated with overall survival, 30-day readmission, and positive surgical margins.
Key findings
- Among 2879 PDAC patients, treatment at low-volume hospitals (by esophageal/rectal cancer NRT volume) was associated with lower overall survival (HR 1.16, 95% CI 1.05-1.29, p = 0.005).
- Low PDAC-specific NRT volume was also associated with lower overall survival (HR 1.25, 95% CI 1.11-1.41); the exact p-value for this comparison is not reported in the available abstract text, which appears truncated.
- Higher institutional NRT volume was associated with lower 30-day readmission rates and fewer positive surgical margins, though specific effect sizes for these outcomes are not reported in the abstract.
- The specific numeric thresholds used to define low- versus high-volume hospitals are not reported in the available abstract text, which appears truncated.
Clinical relevance
The findings suggest that institutional experience with radiotherapy (whether for pancreatic or other GI/thoracic cancers) may be an important factor in outcomes for PDAC patients receiving neoadjuvant radiation, which could be relevant when considering referral to higher-volume centers for this treatment sequence.
Who should care
Limitations
Retrospective registry-based study subject to unmeasured confounding (e.g., patient selection by referral patterns); the abstract text is truncated in several places, omitting exact volume-threshold definitions and some statistical values.
Pancreatic cancer patients receiving neoadjuvant radiation at lower-volume hospitals had worse survival than those at higher-volume centers in this national database study.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction
Neoadjuvant radiation therapy (NRT) is beneficial in gastrointestinal cancers, but its role in pancreatic ductal adenocarcinoma (PDAC) remains uncertain. It is unclear if hospital-level NRT volume is an important factor when treating PDAC with NRT.
Methods
The National Cancer Database (2011-2019) was used to identify PDAC patients who received NRT followed by surgical resection. Hospital NRT volume was defined in two ways: mean annual number of patients treated for (1) PDAC and (2) esophageal/rectal cancers. Hospitals were categorized as low (<90th percentile) or high (≥90th percentile) volume. Multivariable logistic regression and Cox proportional hazards models evaluated associations between hospital NRT volume, overall survival (OS), 30-day readmission, and surgical margin status.
Results
Among 2879 PDAC patients, receiving NRT at low-volume hospitals was associated with lower OS (esophageal/rectal cancer NRT hospital volume, HR 1.16, 95% CI 1.05-1.29, p = 0.005; PDAC NRT hospital volume, HR 1.25, 95% CI 1.11-1.41, p < 0.001). Annual average patient volume of NRT for PDAC at the hospital level as a continuous variable was associated with a decrease in the adjusted log odds of 30-day readmissions and positive surgical margins.
Conclusions
Higher institutional NRT volume was associated with higher OS and lower 30-day readmissions and positive surgical margins among PDAC patients.
DOI
10.1002/jso.70401
PMID
42717553
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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