Variations in Outcomes of Surgical Oncology Fellowship Graduates Performing Hepatopancreatic Surgery in the United States Based on Fellowship Training Program

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Medical Education

Background:

• Hepatopancreatic (HP) surgery outcomes differ among Complex General Surgical Oncology (CGSO) fellowship graduates.
• Real-world data on HP surgery performed by fellowship graduates are limited.

Purpose of the Study:

• To examine real-world outcomes of HP surgery performed by CGSO fellowship graduates.
• To identify variations in outcomes based on fellowship training programs.

Main Methods:

• Medicare data (2016-2021) for patients undergoing HP cancer surgery were analyzed.
• Surgeon fellowship training data were linked to patient outcomes.
• Trends in severe complications and 90-day mortality were assessed by fellowship program.

Main Results:

• Nearly 10,000 HP cancer operations were analyzed, primarily pancreatectomies.
• Significant variations in outcomes were observed among graduates from different CGSO fellowship programs.
• While serious complications decreased over time, 90-day mortality remained stable.

Conclusions:

• CGSO fellowship training significantly impacts HP surgery outcomes.
• Standardization of HP surgery training within CGSO programs is needed.
• Further efforts are required to enhance and standardize HP surgery education for fellows.