Surgery for pancreatic and esophageal cancer in Canada : Chirurgie du cancer du pancréas et de l'oesophage au Canada : expérience de l'hôpital et centralisation des soins

The long-term outlook for those diagnosed with pancreatic or esophageal cancer is dire: only 6% of those with pancreatic cancer and 14% of those with esophageal cancer survive for five years after their diagnosis.4 A strong relationship between the volume of pancreatic and esophageal surgery and outcomes has been well documented in the literature.5–9 Consequently, recommendations to shift care fro [...] Surgery for Pancreatic and Esophageal Cancer in Canada: Hospital Experience and Care Centralization 3 Among hospitals performing these procedures in 2009–2010, there were no high-volume hospitals performing pancreatectomy in New Brunswick or Saskatchewan and no high-volume hospitals performing esophagectomy in New Brunswick. [...] By patient’s province of residence, the degree of centralization of these procedures in high-volume hospitals ranged from 59% in Newfoundland and Labrador to 100% in Prince Edward Island for pancreatectomy and from 13% in Quebec to 89% in British Columbia for esophagectomy (Table 3). [...] The degree of centralization of patients in high-volume hospitals was greater for cancer patients (shown in Table 3) than for other patients (74% versus 66% for pancreatectomy and 58% versus 48% for esophagectomy). [...] Proximity to Care Very few cancer patients had to leave their province or territory to receive surgery (2% for pancreatectomy and 1% for esophagectomy); however, Canadians residing in rural areasv were more likely than urban residents to have to travel outside of their health regionvi for surgical care (74% versus 49% in the case of pancreatectomy and 76% versus 43% in the case of esophagectomy).