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. 2016 Feb;23(2):585-91.
doi: 10.1245/s10434-015-4930-4. Epub 2015 Oct 27.

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

Thijs de Rooij  1 , Johanna A Tol  1 , Casper H van Eijck  2 , Djamila Boerma  3 , Bert A Bonsing  4 , Koop Bosscha  5 , Ronald M van Dam  6 , Marcel G Dijkgraaf  7 , Michael F Gerhards  8 , Harry van Goor  9 , Erwin van der Harst  10 , Ignace H de Hingh  11 , Geert Kazemier  12 , Joost M Klaase  13 , I Quintus Molenaar  14 , Gijs A Patijn  15 , Hjalmar C van Santvoort  1 , Joris J Scheepers  16 , George P van der Schelling  17 , Egbert Sieders  18 , Olivier R Busch  1 , Marc G Besselink  19 ; Dutch Pancreatic Cancer Group
Affiliations

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

Thijs de Rooij et al. Ann Surg Oncol. 2016 Feb.

Abstract

Background: Large multicenter series on outcomes and predictors of survival after distal pancreatectomy (DP) for pancreatic ductal adenocarcinoma (PDAC) are scarce.

Methods: 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.

Results: 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).

Conclusion: 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.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier curve of the cumulative survival probability after distal pancreatectomy for pancreatic ductal adenocarcinoma
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics. CACancer J Clin. 2015;65(1):5–29. doi: 10.3322/caac.21254. - DOI - PubMed
    1. Liu RC, Traverso LW. Diagnostic laparoscopy improves staging of pancreatic cancer deemed locally unresectable by computed tomography. Surg Endosc. 2005;19(5):638–42. - PubMed
    1. Jimenez RE, Warshaw AL, Rattner DW, Willett CG, McGrath D. Fernandez-del Castollo C. Impact of laparoscopic staging in the treatment of pancreatic cancer. Arch Surg. 2000;135(4):409–414. doi: 10.1001/archsurg.135.4.409. - DOI - PubMed
    1. Werner J, Combs SE, Springfield C, Hartwig W, Hackert T, Büchler MW. Advanced-stage pancreatic cancer: therapy options. Nat Rev Clin Oncol. 2013;10(6):323–333. doi: 10.1038/nrclinonc.2013.66. - DOI - PubMed
    1. Sho M, Murakami Y, Motoi F, et al. Postoperative prognosis of pancreatic cancer with para-aortic lymph node metastasis: a multicenter study on 822 patients. J Gastroenterol. 2015;50(6):694–702. doi: 10.1007/s00535-014-1005-4. - DOI - PubMed

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