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Prognostic factors associated with early mortality after surgical resection for pancreatic adenocarcinoma.

Kwak BJ, Kim SC, Song KB, Lee JH, Hwang DW, Park KM, Lee YJ - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: Fifty-three patients who did not meet the study criteria were excluded.Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery.Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Identifying pancreatic cancer patients at high risk of early mortality following surgical resection for pancreatic cancer is important to make optimal treatment decisions in multidisciplinary setting. The purpose of this study was to identify the factors related to early mortality in patients who underwent pancreatic resection for pancreatic adenocarcinoma.

Methods: We reviewed our institution's experience with all consecutive patients who underwent pancreatectomy for pancreatic adenocarcinoma from January 2000 to December 2010. One thousand patients were eligible for our study. Fifty-three patients who did not meet the study criteria were excluded. Based on 12 months after surgery, patients were divided into early mortality group or the remaining group. We performed logistic regression analysis to identify predictors of early mortality.

Results: Among 947 patients who met our study criteria, 302 (31.9%) early mortality (defined as experiencing death within 12 months after surgery) occurred. Multivariate analysis revealed that patient age and surgery time period were statistically significant predictors of early mortality within six months after surgery. Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery. Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery.

Conclusions: We suggest followings to avoid early mortality after pancreatic resection: patients with multiple risk factors related to early mortality after pancreatectomy should be considered for alternative treatment; patient's general condition and surgical technique improvement are important; and adjuvant therapy should be taken into consideration.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier survival curves for patient survival. (A) Disease-free survival rate of all 947 patients who underwent surgical resection for pancreatic adenocarcinoma. Landmark line showing 12 months; (B) Comparison of the disease-free survival rate stratified according to the time period during which surgery was performed.
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Figure 1: Kaplan-Meier survival curves for patient survival. (A) Disease-free survival rate of all 947 patients who underwent surgical resection for pancreatic adenocarcinoma. Landmark line showing 12 months; (B) Comparison of the disease-free survival rate stratified according to the time period during which surgery was performed.

Mentions: The median follow-up for our study population (n=947) was 19.0 months. The median disease-specific survival was 18.6 months. The cumulative survival curve of the study population is shown in Fig. 1. Median disease-specific survival of the early mortality group and the remaining group was 8.3 months and 28.9 months, respectively.


Prognostic factors associated with early mortality after surgical resection for pancreatic adenocarcinoma.

Kwak BJ, Kim SC, Song KB, Lee JH, Hwang DW, Park KM, Lee YJ - Korean J Hepatobiliary Pancreat Surg (2014)

Kaplan-Meier survival curves for patient survival. (A) Disease-free survival rate of all 947 patients who underwent surgical resection for pancreatic adenocarcinoma. Landmark line showing 12 months; (B) Comparison of the disease-free survival rate stratified according to the time period during which surgery was performed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492350&req=5

Figure 1: Kaplan-Meier survival curves for patient survival. (A) Disease-free survival rate of all 947 patients who underwent surgical resection for pancreatic adenocarcinoma. Landmark line showing 12 months; (B) Comparison of the disease-free survival rate stratified according to the time period during which surgery was performed.
Mentions: The median follow-up for our study population (n=947) was 19.0 months. The median disease-specific survival was 18.6 months. The cumulative survival curve of the study population is shown in Fig. 1. Median disease-specific survival of the early mortality group and the remaining group was 8.3 months and 28.9 months, respectively.

Bottom Line: Fifty-three patients who did not meet the study criteria were excluded.Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery.Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Identifying pancreatic cancer patients at high risk of early mortality following surgical resection for pancreatic cancer is important to make optimal treatment decisions in multidisciplinary setting. The purpose of this study was to identify the factors related to early mortality in patients who underwent pancreatic resection for pancreatic adenocarcinoma.

Methods: We reviewed our institution's experience with all consecutive patients who underwent pancreatectomy for pancreatic adenocarcinoma from January 2000 to December 2010. One thousand patients were eligible for our study. Fifty-three patients who did not meet the study criteria were excluded. Based on 12 months after surgery, patients were divided into early mortality group or the remaining group. We performed logistic regression analysis to identify predictors of early mortality.

Results: Among 947 patients who met our study criteria, 302 (31.9%) early mortality (defined as experiencing death within 12 months after surgery) occurred. Multivariate analysis revealed that patient age and surgery time period were statistically significant predictors of early mortality within six months after surgery. Poorly differentiated tumor and adjuvant chemotherapy were statistically significant predictors of early mortality within 12 months after surgery. Total pancreatectomy and lymphovascular invasion were significant (p<0.05) prognostic factors of early mortality within 6 or 12 months after surgery.

Conclusions: We suggest followings to avoid early mortality after pancreatic resection: patients with multiple risk factors related to early mortality after pancreatectomy should be considered for alternative treatment; patient's general condition and surgical technique improvement are important; and adjuvant therapy should be taken into consideration.

No MeSH data available.


Related in: MedlinePlus