{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:40:00Z","timestamp":1790638800324,"version":"4.1.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although the relationship between higher surgical volume and improved outcomes for pancreatic operations is well established, centralizing care to high-volume centers (HVC) may prolong the interval from diagnosis to surgery. This study sought to compare outcomes of patients who had longer wait times for upfront surgery for pancreatic cancer (PDAC) at HVCs with those of patients who underwent earlier surgery at low-volume centers (LVCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing upfront pancreatic surgery for T1-3N0-2M0 PDAC were identified from the 2004\u20132023 National Cancer Database. High-volume centers were defined using Leapfrog criteria as centers performing\u2009\u2265\u200920 pancreatic resections\/year, with others defined as LVCs. Patients who waited more than 28\u00a0days for resection at HVCs were classified as \u201clong wait\/high volume,\u201d whereas those who underwent surgery in\u2009\u2264\u200914\u00a0days at LVCs were classified as \u201cshort wait\/low volume.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 15,310 patients meeting the inclusion criteria, 9598 (63%) were short wait\/low volume and 5712 (37%) were long wait\/high volume. In unadjusted analysis, long wait\/high volume demonstrated superior 5-year survival (23% vs. 19%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, log-rank). After comprehensive risk adjustment, waiting for surgery at an HVC remained associated with reduced mortality hazard during 5\u00a0years of follow-up evaluation (hazard ratio [HR], 0.81; 95% CI, 0.77\u20130.85;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Considering acute endpoints, the long-wait\/high-volume group demonstrated greater likelihood of complete (R0) resection and reduced 30-day mortality, but higher risk of nodal disease and upstaging at resection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Waiting for surgery at an HVC is associated with improved acute outcomes and superior overall survival compared with earlier operations at an LVC. These findings assuage concerns regarding the potential longer wait times for surgery associated with centralization of surgical care for PDAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-19052-4","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T15:32:42Z","timestamp":1768491162000},"page":"4049-4060","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Improved Survival with Delayed Surgery at High-Volume Centers Versus Early Surgery at Low-Volume Centers for Pancreatic Cancer"],"prefix":"10.1245","volume":"33","author":[{"given":"Sara","family":"Sakowitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mampei","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McKensie","family":"Hammons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Donahue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"19052_CR1","doi-asserted-by":"publisher","first-page":"2913","DOI":"10.1158\/0008-5472.CAN-14-0155","volume":"74","author":"L Rahib","year":"2014","unstructured":"Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74:2913\u201321. https:\/\/doi.org\/10.1158\/0008-5472.CAN-14-0155.","journal-title":"Cancer Res."},{"key":"19052_CR2","doi-asserted-by":"publisher","first-page":"1917","DOI":"10.1007\/s11605-011-1665-9","volume":"15","author":"PJ Kneuertz","year":"2011","unstructured":"Kneuertz PJ, Cunningham SC, Cameron JL, et al. Palliative surgical management of patients with unresectable pancreatic adenocarcinoma: trends and lessons learned from a large, single-institution experience. J Gastrointest Surg. 2011;15:1917\u201327. https:\/\/doi.org\/10.1007\/s11605-011-1665-9.","journal-title":"J Gastrointest Surg."},{"key":"19052_CR3","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1136\/gutjnl-2014-308653","volume":"64","author":"J Yu","year":"2015","unstructured":"Yu J, Blackford AL, dal Molin M, Wolfgang CL, Goggins M. Time to progression of pancreatic ductal adenocarcinoma from low-to-high tumour stages. Gut. 2015;64:1783\u20139. https:\/\/doi.org\/10.1136\/gutjnl-2014-308653.","journal-title":"Gut."},{"key":"19052_CR4","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1097\/SLA.0b013e318211cc0f","volume":"253","author":"KY Bilimoria","year":"2011","unstructured":"Bilimoria KY, Ko CY, Tomlinson JS, et al. Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg. 2011;253:779\u201385. https:\/\/doi.org\/10.1097\/SLA.0b013e318211cc0f.","journal-title":"Ann Surg."},{"key":"19052_CR5","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1097\/01.sla.0000252402.33814.dd","volume":"245","author":"JD Birkmeyer","year":"2007","unstructured":"Birkmeyer JD, Sun Y, Wong SL, Stukel TA. Hospital volume and late survival after cancer surgery. Ann Surg. 2007;245:777. https:\/\/doi.org\/10.1097\/01.sla.0000252402.33814.dd.","journal-title":"Ann Surg."},{"key":"19052_CR6","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.hpb.2017.10.017","volume":"20","author":"G Marchegiani","year":"2018","unstructured":"Marchegiani G, Andrianello S, Perri G, et al. Does the surgical waiting list affect pathological and survival outcome in resectable pancreatic ductal adenocarcinoma? HPB. 2018;20:411\u20137. https:\/\/doi.org\/10.1016\/j.hpb.2017.10.017.","journal-title":"HPB."},{"key":"19052_CR7","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/j.hpb.2019.10.013","volume":"22","author":"E Vasilyeva","year":"2020","unstructured":"Vasilyeva E, Li J, Desai S, et al. Impact of surgical wait times on oncologic outcomes in resectable pancreas adenocarcinoma. HPB. 2020;22:892\u20139. https:\/\/doi.org\/10.1016\/j.hpb.2019.10.013.","journal-title":"HPB."},{"key":"19052_CR8","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1007\/s00423-020-01893-0","volume":"405","author":"PC M\u00fcller","year":"2020","unstructured":"M\u00fcller PC, Hodson J, Kuemmerli C, Kalisvaart M, Pande R, Roberts KJ. Effect of time to surgery in resectable pancreatic cancer: a systematic review and meta-analysis. Langenbecks Arch Surg. 2020;405:293\u2013302. https:\/\/doi.org\/10.1007\/s00423-020-01893-0.","journal-title":"Langenbecks Arch Surg."},{"key":"19052_CR9","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1002\/bjs.10046","volume":"103","author":"S Sanjeevi","year":"2016","unstructured":"Sanjeevi S, Ivanics T, Lundell L, et al. Impact of delay between imaging and treatment in patients with potentially curable pancreatic cancer. Br J Surg. 2016;103:267\u201375. https:\/\/doi.org\/10.1002\/bjs.10046.","journal-title":"Br J Surg."},{"key":"19052_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2022.101855","volume":"45","author":"M Frountzas","year":"2022","unstructured":"Frountzas M, Liatsou E, Schizas D, et al. The impact of surgery delay on survival of resectable pancreatic cancer: a systematic review of observational studies. Surg Oncol. 2022;45:101855. https:\/\/doi.org\/10.1016\/j.suronc.2022.101855.","journal-title":"Surg Oncol."},{"key":"19052_CR11","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.surge.2010.03.001","volume":"8","author":"DA Raptis","year":"2010","unstructured":"Raptis DA, Fessas C, Belasyse-Smith P, Kurzawinski TR. Clinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancer. The Surgeon. 2010;8:239\u201346. https:\/\/doi.org\/10.1016\/j.surge.2010.03.001.","journal-title":"The Surgeon."},{"key":"19052_CR12","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1186\/s12893-021-01409-7","volume":"21","author":"M Brugel","year":"2021","unstructured":"Brugel M, Bouch\u00e9 O, Kianmanesh R, et al. Time from first seen in specialist care to surgery does not influence survival outcome in patients with upfront resected pancreatic adenocarcinoma. BMC Surg. 2021;21:413. https:\/\/doi.org\/10.1186\/s12893-021-01409-7.","journal-title":"BMC Surg."},{"key":"19052_CR13","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1016\/j.ejso.2019.05.029","volume":"45","author":"J Kirkeg\u00e5rd","year":"2019","unstructured":"Kirkeg\u00e5rd J, Mortensen FV, Hansen CP, Mortensen MB, Sall M, Fristrup C. Waiting time to surgery and pancreatic cancer survival: a nationwide population-based cohort study. Eur J Surg Oncol. 2019;45:1901\u20135. https:\/\/doi.org\/10.1016\/j.ejso.2019.05.029.","journal-title":"Eur J Surg Oncol."},{"key":"19052_CR14","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1002\/ijc.30166","volume":"139","author":"V Jooste","year":"2016","unstructured":"Jooste V, Dejardin O, Bouvier V, et al. Pancreatic cancer: wait times from presentation to treatment and survival in a population-based study. Int J Cancer. 2016;139:1073\u201380. https:\/\/doi.org\/10.1002\/ijc.30166.","journal-title":"Int J Cancer."},{"key":"19052_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpsurg.2024.101674","volume":"62","author":"CH Wu","year":"2025","unstructured":"Wu CH, Chien KL, Lin JW, Tien YW. Superior surgical outcomes in high-volume centers despite longer waiting times for curative pancreatic surgery compared to shorter waits in low-volume centers: a population-based study. Curr Probl Surg. 2025;62:101674. https:\/\/doi.org\/10.1016\/j.cpsurg.2024.101674.","journal-title":"Curr Probl Surg."},{"key":"19052_CR16","doi-asserted-by":"publisher","unstructured":"Cong L, Liu Q, Zhang R, et al. Tumor size classification of the 8th edition of TNM staging system is superior to that of the 7th edition in predicting the survival outcome of pancreatic cancer patients after radical resection and adjuvant chemotherapy. Sci Rep. 2018; 8: 10383 https:\/\/doi.org\/10.1038\/s41598-018-28193-4.","DOI":"10.1038\/s41598-018-28193-4"},{"key":"19052_CR17","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1467-9868.2005.00503.x","volume":"67","author":"H Zou","year":"2005","unstructured":"Zou H, Hastie T. Regularization and variable selection via the elastic net. J R Stat Soc Ser B Stat Methodol. 2005;67:301\u201320. https:\/\/doi.org\/10.1111\/j.1467-9868.2005.00503.x.","journal-title":"J R Stat Soc Ser B Stat Methodol."},{"key":"19052_CR18","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1111\/insr.12214","volume":"85","author":"PC Austin","year":"2017","unstructured":"Austin PC. A Tutorial on multilevel survival analysis: methods, models, and applications. Int Stat Rev. 2017;85:185\u2013203.","journal-title":"Int Stat Rev."},{"key":"19052_CR19","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1245\/s10434-021-10765-w","volume":"29","author":"AW Acher","year":"2022","unstructured":"Acher AW, Weber SM, Pawlik TM. Does the volume-outcome association in pancreas cancer surgery justify regionalization of care? A review of current controversies. Ann Surg Oncol. 2022;29:1257\u201368. https:\/\/doi.org\/10.1245\/s10434-021-10765-w.","journal-title":"Ann Surg Oncol."},{"key":"19052_CR20","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/SLA.0000000000002248","volume":"267","author":"C Krautz","year":"2018","unstructured":"Krautz C, Nimptsch U, Weber GF, Mansky T, Gr\u00fctzmann R. Effect of hospital volume on in-hospital morbidity and mortality following pancreatic surgery in Germany. Ann Surg. 2018;267:411. https:\/\/doi.org\/10.1097\/SLA.0000000000002248.","journal-title":"Ann Surg."},{"issue":"9849","key":"19052_CR21","doi-asserted-by":"publisher","first-page":"9861","DOI":"10.2147\/CMAR.S221427","volume":"11","author":"G Luk\u00e1cs","year":"2019","unstructured":"Luk\u00e1cs G, Kov\u00e1cs \u00c1, Csan\u00e1di M, et al. Benefits of timely care in pancreatic cancer: a systematic review to navigate through the contradictory evidence. Cancer Manag Res. 2019;11(9849):9861. https:\/\/doi.org\/10.2147\/CMAR.S221427.","journal-title":"Cancer Manag Res."},{"key":"19052_CR22","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.21037\/jgo-24-518","volume":"15","author":"W Wang","year":"2024","unstructured":"Wang W, Wang G, Niu X. Impact of prolonged surgical waiting time on cancer-specific mortality in stage I-II pancreatic ductal adenocarcinoma patients who received radical resection. J Gastrointest Oncol. 2024;15:2663. https:\/\/doi.org\/10.21037\/jgo-24-518.","journal-title":"J Gastrointest Oncol."},{"key":"19052_CR23","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/j.amjsurg.2021.09.036","volume":"223","author":"DS Hsu","year":"2022","unstructured":"Hsu DS, Kumar NS, Le ST, et al. Centralization of pancreatic cancer treatment within an integrated healthcare system improves overall survival. Am J Surg. 2022;223:1035\u20139. https:\/\/doi.org\/10.1016\/j.amjsurg.2021.09.036.","journal-title":"Am J Surg."},{"key":"19052_CR24","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/SLA.0000000000001924","volume":"266","author":"ME Lidsky","year":"2017","unstructured":"Lidsky ME, Sun Z, Nussbaum DP, Adam MA, Speicher PJ, Blazer DGI. Going the extra mile: improved survival for pancreatic cancer patients traveling to high-volume centers. Ann Surg. 2017;266:333. https:\/\/doi.org\/10.1097\/SLA.0000000000001924.","journal-title":"Ann Surg."},{"key":"19052_CR25","doi-asserted-by":"publisher","first-page":"3234","DOI":"10.1200\/JCO.18.02035","volume":"37","author":"KH Sheetz","year":"2019","unstructured":"Sheetz KH, Dimick JB, Nathan H. Centralization of high-risk cancer surgery within existing hospital systems. J Clin Oncol. 2019;37:3234\u201342. https:\/\/doi.org\/10.1200\/JCO.18.02035.","journal-title":"J Clin Oncol."},{"key":"19052_CR26","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1001\/jamasurg.2024.5009","volume":"160","author":"S Sakowitz","year":"2025","unstructured":"Sakowitz S, Bakhtiyar SS, Mallick S, Yanagawa J, Benharash P. Travel to high-volume centers and survival after esophagectomy for cancer. JAMA Surg. 2025;160:19\u201327. https:\/\/doi.org\/10.1001\/jamasurg.2024.5009.","journal-title":"JAMA Surg."},{"key":"19052_CR27","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.jamcollsurg.2011.10.003","volume":"214","author":"WB Al-Refaie","year":"2012","unstructured":"Al-Refaie WB, Muluneh B, Zhong W, et al. Who receives their complex cancer surgery at low-volume hospitals? J Am Coll Surg. 2012;214:81\u20137. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2011.10.003.","journal-title":"J Am Coll Surg."},{"key":"19052_CR28","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.surg.2017.03.010","volume":"162","author":"ZV Fong","year":"2017","unstructured":"Fong ZV, Loehrer AP, Fern\u00e1ndez-del Castillo C, et al. Potential impact of a volume pledge on spatial access: a population-level analysis of patients undergoing pancreatectomy. Surgery. 2017;162:203\u201310. https:\/\/doi.org\/10.1016\/j.surg.2017.03.010.","journal-title":"Surgery."},{"key":"19052_CR29","doi-asserted-by":"publisher","unstructured":"van Roest MHG, van der Aa MA, van der Geest LGM, de Jong KP The impact of socioeconomic status, surgical resection and type of hospital on survival in patients with pancreatic cancer. a population-based study in The Netherlands. PLOS One. 2016 11 e0166449. https:\/\/doi.org\/10.1371\/journal.pone.0166449.","DOI":"10.1371\/journal.pone.0166449"},{"key":"19052_CR30","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.amjsurg.2020.08.023","volume":"221","author":"J Siegel","year":"2021","unstructured":"Siegel J, Engelhardt KE, Hornor MA, Morgan KA, Lancaster WP. Travel distance and its interaction with patient and hospital factors in pancreas cancer care. Am J Surg. 2021;221:819\u201325. https:\/\/doi.org\/10.1016\/j.amjsurg.2020.08.023.","journal-title":"Am J Surg."},{"key":"19052_CR31","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1097\/00005650-199902000-00010","volume":"37","author":"SRG Finlayson","year":"1999","unstructured":"Finlayson SRG, Birkmeyer JD, Tosteson ANA, Nease RFJ. Patient preferences for location of care: implications for regionalization. Med Care. 1999;37:204.","journal-title":"Med Care."},{"key":"19052_CR32","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1056\/NEJMsa1010705","volume":"364","author":"JF Finks","year":"2011","unstructured":"Finks JF, Osborne NH, Birkmeyer JD. Trends in hospital volume and operative mortality for high-risk surgery. N Engl J Med. 2011;364:2128\u201337. https:\/\/doi.org\/10.1056\/NEJMsa1010705.","journal-title":"N Engl J Med."},{"key":"19052_CR33","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1016\/j.amjsurg.2020.01.050","volume":"219","author":"J Cha","year":"2020","unstructured":"Cha J, McKevitt E, Pao JS, Dingee C, Bazzarelli A, Warburton R. Access to surgery following centralization of breast cancer surgical consultations. Am J Surg. 2020;219:831\u20135. https:\/\/doi.org\/10.1016\/j.amjsurg.2020.01.050.","journal-title":"Am J Surg."},{"key":"19052_CR34","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1007\/s13304-019-00677-6","volume":"71","author":"MW Steen","year":"2019","unstructured":"Steen MW, van Vliet C, Festen S, et al. Regional oncology network between pancreatic centers safeguards waiting times for pancreatoduodenectomy. Updat Surg. 2019;71:645\u201351. https:\/\/doi.org\/10.1007\/s13304-019-00677-6.","journal-title":"Updat Surg."},{"key":"19052_CR35","doi-asserted-by":"publisher","first-page":"7002","DOI":"10.1245\/s10434-022-12222-8","volume":"29","author":"NC Schmitt","year":"2022","unstructured":"Schmitt NC, Ryan M, Halle T, et al. Team-based surgical scheduling for improved patient access in a high-volume, tertiary head and neck cancer center. Ann Surg Oncol. 2022;29:7002\u20136. https:\/\/doi.org\/10.1245\/s10434-022-12222-8.","journal-title":"Ann Surg Oncol."},{"key":"19052_CR36","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.jamcollsurg.2015.02.032","volume":"221","author":"CW Kimbrough","year":"2015","unstructured":"Kimbrough CW, McMasters KM, Canary J, et al. Improved operating room efficiency via constraint management: experience of a tertiary-care academic medical center. J Am Coll Surg. 2015;221:154. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2015.02.032.","journal-title":"J Am Coll Surg."},{"key":"19052_CR37","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1097\/SLA.0000000000001560","volume":"264","author":"AC Zenteno","year":"2016","unstructured":"Zenteno AC, Carnes T, Levi R, Daily BJ, Dunn PF. Systematic OR block allocation at a large academic medical center: comprehensive review on a data-driven surgical scheduling strategy. Ann Surg. 2016;264:973. https:\/\/doi.org\/10.1097\/SLA.0000000000001560.","journal-title":"Ann Surg."},{"key":"19052_CR38","doi-asserted-by":"publisher","unstructured":"Unno M, Motoi F, Matsuyama Y, et al. Neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer: results of the randomized phase II\/III Prep-02\/JSAP05 trial. Ann Surg. https:\/\/doi.org\/10.1097\/SLA.0000000000006730","DOI":"10.1097\/SLA.0000000000006730"},{"key":"19052_CR39","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1200\/JCO.21.02233","volume":"40","author":"E Versteijne","year":"2022","unstructured":"Versteijne E, van Dam JL, Suker M, et al. Neoadjuvant chemoradiotherapy versus upfront surgery for resectable and borderline resectable pancreatic cancer: long-term results of the Dutch randomized PREOPANC trial. J Clin Oncol. 2022;40:1220\u201330. https:\/\/doi.org\/10.1200\/JCO.21.02233.","journal-title":"J Clin Oncol."},{"key":"19052_CR40","doi-asserted-by":"publisher","unstructured":"Janssen Q, van Dam JL, Besselink MGH, et al. Total neoadjuvant FOLFIRINOX or gemcitabine-based chemoradiotherapy and adjuvant gemcitabine for resectable and borderline resectable pancreatic cancer (PREOPANC-2): a nationwide multicenter randomized controlled trial. J Clin Oncol. 2021;39(15 Suppl):TPS4171\u2013TPS4171. https:\/\/doi.org\/10.1200\/JCO.2021.39.15_suppl.TPS4171.","DOI":"10.1200\/JCO.2021.39.15_suppl.TPS4171"},{"key":"19052_CR41","doi-asserted-by":"publisher","unstructured":"Chawla A, Shi Q, Ko AH, et al. Alliance A021806: a phase III trial evaluating perioperative versus adjuvant therapy for resectable pancreatic cancer. J Clin Oncol. 2023;41(16 Suppl):TPS4204\u2013TPS4204. https:\/\/doi.org\/10.1200\/JCO.2023.41.16_suppl.TPS4204.","DOI":"10.1200\/JCO.2023.41.16_suppl.TPS4204"},{"issue":"Suppl 2","key":"19052_CR42","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1111\/1475-6773.13996","volume":"57","author":"JI Sanchez","year":"2022","unstructured":"Sanchez JI, Doose M, Zeruto C, et al. Multilevel factors associated with inequities in multidisciplinary cancer consultation. Health Serv Res. 2022;57(Suppl 2):222\u201334. https:\/\/doi.org\/10.1111\/1475-6773.13996.","journal-title":"Health Serv Res."},{"key":"19052_CR43","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1245\/s10434-023-14859-5","volume":"31","author":"J Meier","year":"2024","unstructured":"Meier J, Murimwa G, Nehrubabu M, et al. Effect of hospital cancer designation on use of multimodal therapy and survival of metastatic colorectal cancer: a state-wide analysis. Ann Surg Oncol. 2024;31:2591\u20137. https:\/\/doi.org\/10.1245\/s10434-023-14859-5.","journal-title":"Ann Surg Oncol."},{"key":"19052_CR44","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1245\/s10434-021-10868-4","volume":"29","author":"MF Eskander","year":"2022","unstructured":"Eskander MF, Gil L, Beal EW, et al. Access denied: inequities in clinical trial enrollment for pancreatic cancer. Ann Surg Oncol. 2022;29:1271\u20137. https:\/\/doi.org\/10.1245\/s10434-021-10868-4.","journal-title":"Ann Surg Oncol."},{"key":"19052_CR45","doi-asserted-by":"publisher","first-page":"297","DOI":"10.6004\/jnccn.2019.7361","volume":"18","author":"J Hallet","year":"2020","unstructured":"Hallet J, Davis L, Mahar A, et al. Benefits of high-volume medical oncology care for noncurable pancreatic adenocarcinoma: a population-based analysis. J Natl Compr Cancer Netw JNCCN. 2020;18:297\u2013303. https:\/\/doi.org\/10.6004\/jnccn.2019.7361.","journal-title":"J Natl Compr Cancer Netw JNCCN."}],"container-title":["Annals of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-19052-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1245\/s10434-025-19052-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1245\/s10434-025-19052-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:27:03Z","timestamp":1776256023000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1245\/s10434-025-19052-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":45,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["19052"],"URL":"https:\/\/doi.org\/10.1245\/s10434-025-19052-4","relation":{},"ISSN":["1068-9265","1534-4681"],"issn-type":[{"value":"1068-9265","type":"print"},{"value":"1534-4681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"assertion":[{"value":"7 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Timothy R. Donahue reports serving as a shareholder and executive board member of Trethera Corp. The remaining authors have no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}