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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

Cumulative survival curve of patients who died within 12 months after pancreatic resection (n=302) showing a more rapid downward pattern in the survival curve after 6 months.
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Figure 2: Cumulative survival curve of patients who died within 12 months after pancreatic resection (n=302) showing a more rapid downward pattern in the survival curve after 6 months.

Mentions: Among the 947 patients, 302 (31.9%) had early-mortality (died within 12 months after the surgery), including 235 (77.8%) who died between 6 and 12 months after surgery, which was at least three times of mortality occurred within 6-month after surgery (n=67: 22.2%, Fig. 2). Therefore, we analyzed the prognostic factors based on two time points, i.e., 6 and 12 months after surgery.


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)

Cumulative survival curve of patients who died within 12 months after pancreatic resection (n=302) showing a more rapid downward pattern in the survival curve after 6 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Cumulative survival curve of patients who died within 12 months after pancreatic resection (n=302) showing a more rapid downward pattern in the survival curve after 6 months.
Mentions: Among the 947 patients, 302 (31.9%) had early-mortality (died within 12 months after the surgery), including 235 (77.8%) who died between 6 and 12 months after surgery, which was at least three times of mortality occurred within 6-month after surgery (n=67: 22.2%, Fig. 2). Therefore, we analyzed the prognostic factors based on two time points, i.e., 6 and 12 months after surgery.

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