Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Apr 22:13:12.
doi: 10.1186/1471-2482-13-12.

Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma

Marius Distler  1 , Felix Rückert, Maximilian Hunger, Stephan Kersting, Christian Pilarsky, Hans-Detlev Saeger, Robert Grützmann
Affiliations
Comparative Study

Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma

Marius Distler et al. BMC Surg. .

Abstract

Background: Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma (PDAC). The goal of this study was to investigate the clinical outcome and prognostic factors in patients after resection for ductal adenocarcinoma of the pancreatic head.

Methods: The data from 195 patients who underwent pancreatic head resection for PDAC between 1993 and 2011 in our center were retrospectively analyzed. The prognostic factors for survival after operation were evaluated using multivariate analysis.

Results: The head resection surgeries included 69.7% pylorus-preserving pancreatoduodenectomies (PPPD) and 30.3% standard Kausch-Whipple pancreatoduodenectomies (Whipple). The overall mortality after pancreatoduodenectomy (PD) was 4.1%, and the overall morbidity was 42%. The actuarial 3- and 5-year survival rates were 31.5% (95% CI, 25.04%-39.6%) and 11.86% (95% CI, 7.38%-19.0%), respectively. Univariate analyses demonstrated that elevated CEA (p = 0.002) and elevated CA 19-9 (p = 0.026) levels, tumor grade (p = 0.001) and hard texture of the pancreatic gland (p = 0.017) were significant predictors of a poor survival. However, only CEA >3 ng/ml (p < 0.005) and tumor grade 3 (p = 0.027) were validated as significant predictors of survival in multivariate analysis.

Conclusions: Our results suggest that tumor marker levels and tumor grade are significant predictors of poor survival for patients with pancreatic head cancer. Furthermore, hard texture of the pancreatic gland appears to be associated with poor survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier analysis of overall survival of patients with PDAC of the pancreatic head after PD; the 3- and 5-year survival rates were 31.5% (95% CI, 25.04%-39.6%) and 11.86% (95% CI, 7.38%-19.0%), respectively.
See this image and copyright information in PMC

References

    1. Sommerville CA, Limongelli P, Pai M. Establishment of a preclinical ovine model for tibial segmental bone defect repair by applying bone tissue engineering strategies. J Surg Oncol. 2009;100(8):651–656. doi: 10.1002/jso.21390. - DOI - PubMed
    1. Richter A, Niedergethmann M, Sturm JW. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience. World J Surg. 2003;27(3):324–329. doi: 10.1007/s00268-002-6659-z. Epub 2003 Feb 27. - DOI - PubMed
    1. Winter JM, Cameron JL, Campbell KA. 1423 Pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg. 2006;10(9):1199–1210. doi: 10.1016/j.gassur.2006.08.018. discussion 1210–1. - DOI - PubMed
    1. Neoptolemos JP, Stocken DD, Tudur Smith C. Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the ESPAC-1 and −3(v1) trials. Br J Cancer. 2009;100(2):246–250. doi: 10.1038/sj.bjc.6604838. - DOI - PMC - PubMed
    1. Oettle H, Post S, Neuhaus P, Gellert K. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007;297(3):267–277. doi: 10.1001/jama.297.3.267. - DOI - PubMed