Is pancreatic fistula associated with worse overall survival in patients with pancreatic carcinoma?

Abstract

Background: Pancreatic fistula (PF) is one of the leading complications after pancreatic resection for pancreatic carcinoma. The aim of this study was to determine whether PF was associated with deterioration of long-term outcomes in patients with pancreatic carcinoma after surgical resection.

Methods: Medical records of 210 patients with pancreatic carcinoma who underwent tumor resection were reviewed retrospectively. PF was defined as grade B or C PF according to the criteria of the International Study Group on Pancreatic Fistula. Clinicopathological factors including overall survival were compared between patients with and without PF by univariate and multivariate analyses.

Results: Thirty-one patients (15 %) developed postoperative PF, and 179 (85 %) did not. The 31 cases of PF consisted of 27 grade B PF and 4 grade C PF. There were no differences in the use of adjuvant chemotherapy, tumor differentiation, lymph node status, surgical margin status, or UICC stage between groups. Overall 5-year survival rates for patients with and without PF were 25 and 27 %, respectively. There was no significant difference in overall survival between the two groups (P = 0.743). Multivariate analysis demonstrated that the use of postoperative adjuvant chemotherapy (P < 0.001), tumor differentiation (P = 0.005), and lymph node metastasis (p < 0.001) were factors independently associated with overall survival.

Conclusions: These results suggested that PF was not associated with deterioration of long-term outcomes in patients with pancreatic carcinoma. However, further analyses on larger number of patients are needed to determine a negative effect of grade C PF on long-term survival.