Designing a national network of pancreas units: the Italian model for high-quality pancreatic cancer care
Year: 2026
Type: article
Abstract: Pancreatic and periampullary cancers are among the most challenging malignancies. Centralization of care and multidisciplinary management have been associated with improved outcomes. In 2024,the Italian Ministry of Health established a national Steering Committee with the objective of defining a centralized model for the management of pancreatic and periampullary diseases and identifying the minimum requirements for referral centers across Italy. The Steering Committee met every four weeks through plenary and focused working groups. Using data from the National Agency for Regional Health Services and the National Outcome Program, all ICD-9 codes related to pancreatic, periampullary, and distal biliary diseases were analyzed. Criteria were developed according to international recommendations and structured into a Hub-and-Spoke network model. Pancreas Units(Hub centers) were defined as hospitals providing 24/7 multidisciplinary expertise, advanced diagnostic and interventional capabilities, and a minimum surgical volume of ≥ 30 pancreatic resections per year with 90-day mortality < 10% (target < 5% within 3 years). Spoke centers were required to adhere to standardized diagnostic–therapeutic pathways and participate in multidisciplinary team meetings, without performing pancreatic surgery. Based on catchment area analyses, one Hub center per 700,000–1,200,000 inhabitants was recommended. Additional requirements included structured multidisciplinary processes, standardized diagnostic pathways, and integration with national research and training networks. This national model provides a comprehensive framework for centralizing pancreatic and periampullary diseases care. By defining minimum standards, enhancing multidisciplinary coordination, and concentrating complex procedures in high-performance centers, this initiative aims to improve outcomes, reduce regional disparities, and create a sustainable national Pancreas Unit network.
Source: Updates in Surgery
Authors: Sergio Alfieri, Giuseppe Quero, Vincenzo Tondolo, Giampaolo Balzano, Antonella Cardone, Giovanni Conzo, Carlo Fabbri, Viviana Ferrari, Luca Frulloni, Salvatore Gruttadauria, Elisabetta Ianelli, Evaristo Maiello, Roberta Menghi, Michele Milella, Michele Reni, Roberto Salvia, Cristiano Spada, Manuela Tamburo De Bella, Ilaria Tarantino, Giampaolo Tortora, Federica Valsecchi, Leonardo Vincenti, Fabio Vistoli, Ugo Boggi
Institutions: Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Fatebenefratelli Hospital, Ospedale di Circolo e Fondazione Macchi, University of Campania "Luigi Vanvitelli", Azienda Unità Sanitaria Locale Della Romagna, University of Verona, University of Catania, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Casa Sollievo della Sofferenza, IRCCS Ospedale San Raffaele, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Azienda Ospedaliera Universitaria Integrata Verona, Fondazione Nadia Valsecchi, Gastroenterology Hospital "Saverio de Bellis", University of L'Aquila, University of Pisa
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,790
OpenAlex ID: W7140179206