Association of Cancer Center Designation with Multimodality Treatment, Perioperative Outcomes, and Survival among Older Adults with Pancreatic Ductal Adenocarcinoma
In brief
NCI-designated centers halve one-year mortality for older pancreatic cancer patients
In a SEER-Medicare analysis of nearly 13,000 patients age 76 median, 56% received multimodality therapy at NCI-designated hospitals versus about 34% at other centers, and surgery was performed in more than twice as many. After adjustment, treatment at NCI centers cut one-year death risk by roughly 50%. The study underscores the survival advantage of directing older PDAC patients to high-volume, coordinated cancer centers, but access remains uneven.
- Journal
- Annals of surgical oncology (Q1)
- Published
- 6 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Meher Angez, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Areesh Mevawalla, Elemosho Abdulaziz, Qaidar Alizai, et al.
- PMID
- 42560641
- DOI
- 10.1245/s10434-026-20337-5
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 7 August 2026).
Abstract
BACKGROUND: 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. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.