Outcomes of Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma in the Netherlands: A Nationwide Retrospective Analysis

Large multicenter series on outcomes and predictors of survival after distal pancreatectomy (DP) for pancreatic ductal adenocarcinoma (PDAC) are scarce. Adults who underwent DP for PDAC in 17 Dutch pancreatic centers between January 2005 and September 2013 were analyzed retrospectively. The primary outcome was survival, and predictors of survival were identified using Cox regression analysis. In total, 761 consecutive patients after DP were assessed, of whom 620 patients were excluded because of non-PDAC histopathology (n = 616) or a lack of data (n = 4), leaving a total of 141 patients includ... Mehr ...

Verfasser: de Rooij, Thijs
Tol, Johanna A.
van Eijck, Casper H.
Boerma, Djamila
Bonsing, Bert A.
Bosscha, Koop
van Dam, Ronald M.
Dijkgraaf, Marcel G.
Gerhards, Michael F.
van Goor, Harry
van der Harst, Erwin
de Hingh, Ignace H.
Kazemier, Geert
Klaase, Joost M.
Molenaar, I. Quintus
Patijn, Gijs A.
van Santvoort, Hjalmar C.
Scheepers, Joris J.
van der Schelling, George P.
Sieders, Egbert
Busch, Olivier R.
Besselink, Marc G.
Dokumenttyp: Artikel
Erscheinungsdatum: 2016
Reihe/Periodikum: de Rooij , T , Tol , J A , van Eijck , C H , Boerma , D , Bonsing , B A , Bosscha , K , van Dam , R M , Dijkgraaf , M G , Gerhards , M F , van Goor , H , van der Harst , E , de Hingh , I H , Kazemier , G , Klaase , J M , Molenaar , I Q , Patijn , G A , van Santvoort , H C , Scheepers , J J , van der Schelling , G P , Sieders , E , Busch , O R & Besselink , M G 2016 , ' Outcomes of Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma in the Netherlands: A Nationwide Retrospective Analysis ' , Annals of Surgical Oncology , vol. 23 , no. 2 , pp. 585-591 . https://doi.org/10.1245/s10434-015-4930-4
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29187187
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://cris.maastrichtuniversity.nl/en/publications/85585d39-2edd-4c01-9d61-926c64e4a521

Large multicenter series on outcomes and predictors of survival after distal pancreatectomy (DP) for pancreatic ductal adenocarcinoma (PDAC) are scarce. Adults who underwent DP for PDAC in 17 Dutch pancreatic centers between January 2005 and September 2013 were analyzed retrospectively. The primary outcome was survival, and predictors of survival were identified using Cox regression analysis. In total, 761 consecutive patients after DP were assessed, of whom 620 patients were excluded because of non-PDAC histopathology (n = 616) or a lack of data (n = 4), leaving a total of 141 patients included in the study [45 % (n = 63) male, mean age 64 years (SD = 10)]. Multivisceral resection was performed in 43 patients (30 %) and laparoscopic resection was performed in 7 patients (5 %). A major complication (Clavien-Dindo score of III or higher) occurred in 46 patients (33 %). Mean tumor size was 44 mm (SD 23), and histopathological examination showed 70 R0 resections (50 %), while 30-day and 90-day mortality was 3 and 6 %, respectively. Overall, 63 patients (45 %) received adjuvant chemotherapy. Median survival was 17 months [interquartile range (IQR) 13-21], with a median follow-up of 17 months (IQR 8-29). Cumulative survival at 1, 3 and 5 years was 64, 29, and 22 %, respectively. Independent predictors of worse postoperative survival were R1/R2 resection [hazard ratio (HR) 1.6, 95 % confidence interval (CI) 1.1-2.4], pT3/pT4 stage (HR 1.9, 95 % CI 1.3-2.9), a major complication (HR 1.7, 95 % CI 1.1-2.5), and not receiving adjuvant chemotherapy (HR 1.5, 95 % CI 1.0-2.3). Survival after DP for PDAC is poor and is related to resection margin, tumor stage, surgical complications, and adjuvant chemotherapy. Further studies should assess to what extent prevention of surgical complications and more extensive use of adjuvant chemotherapy can improve survival.