Curative-intent surgery for pancreatic tumors: A review of procedures from the Brazilian national health system

Lucas V. dos Santos, Marco Antonio O. Lessa, João Paulo S.N. Lima, Benjamin Haaland, Gilberto L. Lopes

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Purpose In Brazil, a country with major health access disparities, resource limitations make management of pancreatic cancer (PC) challenging. This study evaluated curative-intent surgery for PC in the Brazilian public health care system. Methods We collected data for PC surgical procedures with curative intent in Brazil’s public health care system (DATASUS) and from the demographic database. Costs, lengths of stay, number of perioperative deaths, and PC deaths were analyzed for each state and then associated with population, gross domestic product (GDP) per capita, and number of procedures. Results A total of 37,142 patients died as a result of PC in Brazil between 2008 and 2012. The number of deaths (per 100,000 person-years) was highest in the south and southeast regions. Mortality from PC had a positive association with the number of procedures and GDP per capita. Between January 2008 and July 2014, 3,386 procedures were performed, the majority (51.2%) in the southeast region. Four hundred ninety-three patients died, which translates to an inpatient mortality rate of 14.6%. The northern states had the highest perioperative mortality (mean, 25%). The number of procedures per 100,000 residents was higher in the southeast and south. Overall, cost tended to increase as the number of procedures or population increased. For fixed GDP per capita and population, cost tended to increase as the number of procedures increased, whereas for a fixed number of procedures and GDP per capita, cost tended to decrease as population increased. The mean length of hospital stay was 16.9 days, which was higher than in major international centers. Conclusion This study is the first to our knowledge to evaluate regional disparities in PC care in Brazil. Perioperative mortality was high in the public health care system. Regionalized policies that improve care are needed.

Original languageEnglish (US)
Pages (from-to)37-42
Number of pages6
JournalJournal of Global Oncology
Volume3
Issue number1
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Curative-intent surgery for pancreatic tumors: A review of procedures from the Brazilian national health system'. Together they form a unique fingerprint.

Cite this