| Increasing time delay from presentation until surgical referral for hepatobiliary malignancies. | |
| | |
MedLine Citation:
|
PMID: 20961373 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Studies have shown that delayed treatment of several non-hepatobiliary (HB) malignancies is associated with adverse effects on disease progression and survival. Delayed treatment of HB malignancies has not been thoroughly investigated. METHODS: We performed a retrospective institutional review of patients referred to the Hepatobiliary Surgery Service at Beth Israel Deaconess Medical Center (BIDMC) for hepatobiliary malignancies from 2002 to 2008. Primary outcomes included the time delays (TD) in patient workup. Secondary outcomes were reasons for delay as well as disparities in TD based on demographic factors. RESULTS: Multivariate-adjusted linear regression showed a significant trend of increasing time from presentation until referral to a HB surgeon over the 7-year period (P= 0.001). There were no differences in TD by gender, age or education level. Multivariate-adjusted linear regression showed a significant trend of increasing number of imaging tests performed prior to referral [computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and ultrasound and endoscopic ultrasound (US/EUS)] (P < 0.001). Multivariate-adjusted linear regression in resectable patients showed a significant difference in overall length of survival in those with a TD1 > 30 days compared with those with a TD1 (TD from presentation until referral) <30 days (P = 0.042). CONCLUSIONS: Delays were associated with an increase in imaging studies and delays adversely affect survival in resected patients. Referring physicians are encouraged to expedite the evaluation and early referral of all patients to an HB surgeon for evaluation and treatment. |
| | |
Authors:
|
Kristopher P Croome; Robyn Chudzinski; Douglas W Hanto |
Related Documents
:
|
20880773 - Proforma-based reporting in rectal cancer. 16181843 - Cost effectiveness of chest computed tomography after lung cancer resection: a decision... 18292633 - Visual field defect as a presenting sign for hemorrhagic stroke caused by sildenafil. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: HPB : the official journal of the International Hepato Pancreato Biliary Association Volume: 12 ISSN: 1477-2574 ISO Abbreviation: HPB (Oxford) Publication Date: 2010 Nov |
Date Detail:
|
Created Date: 2010-10-21 Completed Date: 2011-03-21 Revised Date: 2011-11-01 |
Medline Journal Info:
|
Nlm Unique ID: 100900921 Medline TA: HPB (Oxford) Country: England |
Other Details:
|
Languages: eng Pagination: 644-8 Citation Subset: IM |
Copyright Information:
|
© 2010 International Hepato-Pancreato-Biliary Association. |
Affiliation:
|
Center for Transplant Outcomes and Quality Improvement, The Transplant Institute at Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA. krisbelize@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Biliary Tract Neoplasms
/
diagnosis,
mortality,
surgery* Boston Digestive System Surgical Procedures* Endosonography Female Humans Linear Models Liver Neoplasms / diagnosis, mortality, surgery* Logistic Models Magnetic Resonance Imaging Male Middle Aged Odds Ratio Pancreatic Neoplasms / diagnosis, mortality, surgery* Positron-Emission Tomography Referral and Consultation* Retrospective Studies Risk Assessment Risk Factors Time Factors Tomography, X-Ray Computed Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Longterm follow-up after transarterial chemotherapy for hepatocellular carcinoma in a Scandinavian c...
Next Document: Resection margin in laparoscopic hepatectomy: a comparative study between wedge resection and anatom...