Postoperative pancreatic fistulas decrease the survival of pancreatic cancer patients treated with surgery after neoadjuvant chemoradiotherapy: A retrospective analysis.
Aged
Aged, 80 and over
Chemoradiotherapy
/ adverse effects
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoadjuvant Therapy
/ mortality
Pancreatectomy
/ adverse effects
Pancreatic Fistula
/ etiology
Pancreatic Neoplasms
/ mortality
Postoperative Complications
/ etiology
Prognosis
Retrospective Studies
Survival Rate
Neoadjuvant therapy
Pancreatic cancer
Pancreatic fistula
Journal
Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
16
08
2020
revised:
13
10
2020
accepted:
19
10
2020
pubmed:
8
11
2020
medline:
9
10
2021
entrez:
7
11
2020
Statut:
ppublish
Résumé
A postoperative pancreatic fistula (POPF) is a critical complication after surgery for pancreatic cancer. Whether a POPF affects the long-term prognosis of pancreatic cancer cases remains controversial. This study aimed to clarify the effect of a POPF on the long-term prognosis of pancreatic cancer patients, especially after neoadjuvant chemoradiotherapy (NACRT). Patients who underwent curative pancreatectomy for pancreatic cancer between January 2012 and June 2019 at Kyoto University Hospital were retrospectively investigated. A fistula ≥ Grade B was considered a POPF. During the study period, 148 patients underwent upfront surgery (Upfront group), and 52 patients underwent surgery after NACRT (NACRT group). A POPF developed in 16% of patients in the Upfront group and 13% in the NACRT group (p = 0.824). In the Upfront group, development of a POPF did not have a significant effect on recurrence-free survival (p = 0.766) or overall survival (p = 0.863). However, in the NACRT group, development of a POPF significantly decreased recurrence-free survival (HR 5.856, p = 0.002) and overall survival (HR 7.097, p = 0.020) on multivariate analysis. The development of a POPF decreases the survival of pancreatic cancer patients treated by surgery after NACRT.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
A postoperative pancreatic fistula (POPF) is a critical complication after surgery for pancreatic cancer. Whether a POPF affects the long-term prognosis of pancreatic cancer cases remains controversial. This study aimed to clarify the effect of a POPF on the long-term prognosis of pancreatic cancer patients, especially after neoadjuvant chemoradiotherapy (NACRT).
METHODS
METHODS
Patients who underwent curative pancreatectomy for pancreatic cancer between January 2012 and June 2019 at Kyoto University Hospital were retrospectively investigated. A fistula ≥ Grade B was considered a POPF.
RESULTS
RESULTS
During the study period, 148 patients underwent upfront surgery (Upfront group), and 52 patients underwent surgery after NACRT (NACRT group). A POPF developed in 16% of patients in the Upfront group and 13% in the NACRT group (p = 0.824). In the Upfront group, development of a POPF did not have a significant effect on recurrence-free survival (p = 0.766) or overall survival (p = 0.863). However, in the NACRT group, development of a POPF significantly decreased recurrence-free survival (HR 5.856, p = 0.002) and overall survival (HR 7.097, p = 0.020) on multivariate analysis.
CONCLUSIONS
CONCLUSIONS
The development of a POPF decreases the survival of pancreatic cancer patients treated by surgery after NACRT.
Identifiants
pubmed: 33160278
pii: S0960-7404(20)30418-7
doi: 10.1016/j.suronc.2020.10.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
527-532Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.