Pancreatic & liver cancer surgery specialist centres NSW
Criteria for a specialist pancreatic cancer, liver cancer, and cholangiocarcinoma surgery
A pancreatectomy is surgery to remove of all or part of the pancreas. It is complex surgery, which requires a team of health care professionals with suitable experience performing this surgery and providing supportive care after surgery.[1-2]
Surgery for cancers of the liver or biliary system (hepatocellular carcinoma and cholangiocarcinoma) is also complex and requires similar care to pancreatectomy.
Australian and international studies indicate that patient outcomes can be improved when these types of complex surgeries are performed in centres that do a high number of these procedures.[3-4]
It is recommended that specialist pancreatic and liver cancer centres perform 6 pancreatectomies per year*
* The minimum suggested annual surgical caseload for a cancer specialist centre is six pancreatectomies per year. This threshold has been selected based on international studies, the hospital-level distribution of pancreatectomies in NSW, and consultation with clinicians.
It is based on the number of pancreatectomies only. Due to similarities in anatomy, surgical complexity, and supportive care required centres will be recommended for all of these cancer types if they meet the minimum suggested annual surgical caseload for pancreatectomy.
Multidisciplinary cancer care team availability
Patients with cancers of the pancreas, liver or biliary system may have one or more types of treatment, including surgery, endoscopic treatments, chemotherapy, radiotherapy, and tumour ablation or embolization.
The involvement of a multidisciplinary cancer care team is required.[5-6] This team brings together health care professionals from different specialties to discuss a patient’s cancer diagnosis and staging, and their treatment options. It also enhances communication and care co-ordination between the specialists involved in a patient’s care.
Australian and international studies show that patients overseen by a multidisciplinary cancer care team experience better outcomes after cancer treatment.[5-6]
Actions for Health Professionals
Patient referral
Patients with a suspected or confirmed cancer of the pancreas, liver or biliary tract should be referred to a specialist who is a member of a multidisciplinary cancer care team and practices at one of the specialist centres listed below.
Even if surgery does not seem likely at the time of referral, involvement of a multidisciplinary team (MDT) early in the cancer journey is recommended to ensure optimal assessment, care, and outcomes.
The Canrefer website allows you to find cancer specialists who are MDT members, and has information about cancer services, optimal care pathways, and patient resources.
Smoking cessation support
Evidence suggests that tobacco cessation following cancer diagnosis improves survival. It also reduces treatment-related complications.[7-8] Health professionals should discuss tobacco use with all patients and provide appropriate cessation support.
List of public specialist centres for pancreatic cancer, primary liver cancer, and cholangiocarcinoma surgery
List of private specialist centres for pancreatic cancer, primary liver cancer, and cholangiocarcinoma surgery
| Local health district | Hospital | Annual average pancreatectomy caseload Jul 2020 – Jun 2022 | Multidisciplinary cancer care team |
|---|---|---|---|
Northern Sydney | North Shore Private | 36-40 | Royal North Shore Hospital Upper Gastrointestinal Cancer MDT |
Sydney | Chris O'Brien Lifehouse | 17-20 | Royal Prince Alfred and Lifehouse Upper Gastrointestinal Cancer MDT |
| Western Sydney | Norwest Private | 17-20 | Western Sydney Local Health District Liver Cancer MDT |
South Eastern Sydney | Prince of Wales Private | 17-20 | Prince of Wales Gastro-Oesophageal Cancer MDT |
South Eastern Sydney | St George Private | 13-18 | St George Cancer Care Centre Upper Gastrointestinal Cancer MDT |
Hunter New England | Newcastle Private | 9-12 | Hunter New England Gastrointestinal Cancer MDT |
| Northern Sydney | Sydney Adventist | 9-12 | Sydney Adventist Hospital Gastrointestinal Cancer MDT |
| South Eastern Sydney | St Vincent's Private | 6-8 | The Kinghorn Cancer Centre Upper Gastrointestinal Cancer MDT |
Codes
- Surgical caseload data sourced from Admitted Patient, Emergency Department Attendance, and Deaths Register (APEDDR) via Secure Analytics for Population Health Research and Intelligence (SAPHaRI), Centre for Epidemiology and Evidence, NSW Ministry of Health.
- In-scope diagnoses (pancreatic cancer): C17.0, C24, C25
- In-scope procedures (pancreatectomy): 30583–00, 30584–00, 30593–00, 30593–01
- The data presented are for pancreatectomy only. Co-listing for liver resection is based on meeting the minimum suggested annual caseload for pancreatectomy.
References
- Ban D, Garbarino GM, Ishikawa Y, Honda G, Jang JY, Kang CM, et al. Surgical approaches for minimally invasive distal pancreatectomy: A systematic review. Journal of Hepato‐Biliary‐Pancreatic Sciences. 2022;29(1):151-60.
- Jabłońska B, Mrowiec S. Pancreatectomy and Pancreatic Surgery. MDPI; 2023. p. 1400.
- Ahola R, Sand J, Laukkarinen J. Centralization of pancreatic surgery improves results. Scandinavian Journal of Surgery. 2020;109(1):4-10.
- Polonski A, Izbicki JR, Uzunoglu FG. Centralization of pancreatic surgery in Europe. Journal of Gastrointestinal Surgery. 2019;23:2081-92.
- Kirkegård J, Al‐Saiddi M, Bratlie SO, Coolsen M, de Haas RJ, den Dulk M, et al. Intra‐observer agreements in multidisciplinary team assessments of pancreatic cancer patients. Journal of Surgical Oncology. 2021;124(8):1402-8.
- Li J, Xu Y, Ding N, Ji Y, Liu L, Rao S, et al. Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients. Zhonghua wai ke za zhi [Chinese Journal of Surgery]. 2022;60(7):666-73.
- Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Translational lung cancer research. 2019;8(Suppl 1):S50.
- Warren GW, Alberg AJ, Cummings KM, Dresler C. Smoking cessation after a cancer diagnosis is associated with improved survival. Journal of Thoracic Oncology. 2020;15(5):705-8.
