Association of Cancer Center Designation with Multimodality Treatment, Perioperative Outcomes, and Survival among Older Adults with Pancreatic Ductal Adenocarcinoma.

Authors

Meher Angez, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Areesh Mevawalla, Elemosho Abdulaziz, Qaidar Alizai, Rabia Bega, Rida Ejaz, Timothy M Pawlik

Published in

Annals of surgical oncology. Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Cancer center designation may influence treatment patterns and outcomes for patients with pancreatic ductal adenocarcinoma (PDAC); comparative data across non-designated (ND), Commission on Cancer/American College of Surgeons (CoC/ACS), and National Cancer Institute (NCI)-designated centers remain limited. We evaluated associations between designation, multimodality treatment, perioperative outcomes, and survival in stage I-III PDAC.
The analytic cohort consisted of patients with stage I-III PDAC in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2005-2019), while patients with stage IV disease were assessed using descriptive comparisons. Multivariable models were utilized to assess associations between center designation and outcomes of interest.
Among 12,971 patients, median age was 76 years (IQR 71-81 years), and 54.6% (n = 7083) were female. Most patients received care at non-NCI CoC (42.0%, n = 5446) or NCI-designated centers (39.8%, n = 5,164). Nurse-to-bed ratios were higher at NCI-designated centers (1.61, IQR 1.25-2.22) and non-NCI CoC centers (1.19, IQR 0.91-1.52) compared with ND centers (0.93, IQR 0.60-1.30) (p < 0.001). Multimodality treatment within 180 days post-surgery was more common at NCI centers (56.2%, n = 1327) versus non-NCI CoC (34.2%, n = 1861) and ND centers (33.4%, n = 1725). In adjusted analyses, care at NCI-designated centers was associated with higher odds of undergoing surgical resection (aOR 2.37, 95% CI 2.12-2.65) and lower 1-year mortality hazard (aHR 0.50, 95% CI 0.46-0.54) compared with ND centers.
Compared with non-designated centers, care at NCI-designated centers was associated with greater use of multimodality therapy and improved survival among patients with stage I-III PDAC, whereas non-NCI CoC centers demonstrated outcomes that were generally closer to non-designated centers than to NCI-designated centers. These findings highlight the importance of access to centers delivering coordinated multimodality PDAC care.

PMID:
42560641
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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