Five-year recurrence/survival after pancreatoduodenectomy for pancreatic adenocarcinoma: does pre-existing diabetes matter? Results from the Recurrence After Whipple's (RAW) study.

Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association

ISSN: 1477-2574

Titre abrégé: HPB (Oxford)

Pays: England

ID NLM: 100900921

Informations de publication

Date de publication:
26 Apr 2024

Historique:

received: 09 09 2023

revised: 27 03 2024

accepted: 19 04 2024

medline: 17 5 2024

pubmed: 17 5 2024

entrez: 16 5 2024

Statut: aheadofprint

Résumé

Diabetes mellitus (DM) has a complex relationship with pancreatic cancer. This study examines the impact of preoperative DM, both recent-onset and pre-existing, on long-term outcomes following pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). Data were extracted from the Recurrence After Whipple's (RAW) study, a multi-centre cohort of PD for pancreatic head malignancy (2012-2015). Recurrence and five-year survival rates of patients with DM were compared to those without, and subgroup analysis performed to compare patients with recent-onset DM (less than one year) to patients with established DM. Out of 758 patients included, 187 (24.7%) had DM, of whom, 47 of the 187 (25.1%) had recent-onset DM. There was no difference in the rate of postoperative pancreatic fistula (DM: 5.9% vs no DM 9.8%; p = 0.11), five-year survival (DM: 24.1% vs no DM: 22.9%; p = 0.77) or five-year recurrence (DM: 71.7% vs no DM: 67.4%; p = 0.32). There was also no difference between patients with recent-onset DM and patients with established DM in postoperative outcomes, recurrence, or survival. We found no difference in five-year recurrence and survival between diabetic patients and those without diabetes. Patients with pre-existing DM should be evaluated for PD on a comparable basis to non-diabetic patients.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

Data were extracted from the Recurrence After Whipple's (RAW) study, a multi-centre cohort of PD for pancreatic head malignancy (2012-2015). Recurrence and five-year survival rates of patients with DM were compared to those without, and subgroup analysis performed to compare patients with recent-onset DM (less than one year) to patients with established DM.

RESULTS RESULTS

Out of 758 patients included, 187 (24.7%) had DM, of whom, 47 of the 187 (25.1%) had recent-onset DM. There was no difference in the rate of postoperative pancreatic fistula (DM: 5.9% vs no DM 9.8%; p = 0.11), five-year survival (DM: 24.1% vs no DM: 22.9%; p = 0.77) or five-year recurrence (DM: 71.7% vs no DM: 67.4%; p = 0.32). There was also no difference between patients with recent-onset DM and patients with established DM in postoperative outcomes, recurrence, or survival.

CONCLUSION CONCLUSIONS

We found no difference in five-year recurrence and survival between diabetic patients and those without diabetes. Patients with pre-existing DM should be evaluated for PD on a comparable basis to non-diabetic patients.

Identifiants

DOI: 10.1016/j.hpb.2024.04.010 PMID: 38755085

pubmed: 38755085

pii: S1365-182X(24)01276-0

doi: 10.1016/j.hpb.2024.04.010

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

None Lead Unit

Somaiah Aroori (S)

Peter L Labib (PL)

Thomas B Russell (TB)

Adam Streeter (A)

Jemimah Denson (J)

Mark Puckett (M)

Shang-Ming Zhou (SM)

Matthew Browning (M)

None Collaborating Units

Fabio Ausania (F)

Carolina Gonzalez-Abos (C)

Elizabeth Pando (E)

Nair Fernandes (N)

Elsa G Moller (EG)

Cristina D Taboada (CD)

Keith Roberts (K)

Rupaly Pande (R)

Jameel Alfarah (J)

Ambareen Kausar (A)

Samik Bandyopadhyay (S)

Ahmed Abdelrahim (A)

Ayesha Khan (A)

Vasileios K Mavroeidis (VK)

Caitlin Jordan (C)

Jonathan R E Rees (JRE)

Gabriele Marangoni (G)

Harry Blege (H)

Sarah Thomasset (S)

William Cambridge (W)

Olga White (O)

Adam Frampton (A)

Sarah Blacker (S)

Jessie Blackburn (J)

Casie Sweeney (C)

Pavlos Lykoudis (P)

Daniel Field (D)

Mohammed Gouda (M)

Manuel Maglione (M)

Ruben Bellotti (R)

Nassir Alhaboob (N)

Hytham K S Hamid (HKS)

Hassaan Bari (H)

Hassan Ahmed (H)

Andrew Smith (A)

Catherine Moriarty (C)

Louise White (L)

Mark Priestley (M)

Kerry Bode (K)

Judith Sharp (J)

Rosie Wragg (R)

Beverley Jackson (B)

Samuel Craven (S)

Duncan Spalding (D)

Matyas Fehervari (M)

Madhava Pai (M)

Laith Alghazawi (L)

Anjola Onifade (A)

Parthi Srinivasan (P)

Julliette Ribaud (J)

Ashitha Nair (A)

Michael Mariathasan (M)

Niamh Grayson (N)

Brian Davidson (B)

Stephanos Pericleous (S)

Krishna Patel (K)

Conrad Shaw (C)

Nolitha Morare (N)

Mohamad K Zaban (MK)

Ricky Bhogal (R)

Joseph Doyle (J)

Daniel Croagh (D)

Ashray Rajagopalan (A)

Ismael Dominguez (I)

Alan Guerrero (A)

Andre Moguel (A)

Carlos Chan (C)

Rohan Thakkar (R)

Michael Jones (M)

Edward Buckley (E)

Nasreen Akter (N)

Kyle Treherne (K)

Dhanny Gomez (D)

Gregory Gordon (G)

Michael Silva (M)

Daniel Hughes (D)

Tomas Urbonas (T)

Pierfrancesco Lapolla (P)

Andrea Mingoli (A)

Gioia Brachini (G)

Roberto Caronna (R)

Piero Chirletti (P)

Alberto Porcu (A)

Teresa Perra (T)

Nehal S Shah (NS)

Nurul N Abd Kahar (NN)

Thomas Hall (T)

Nabeegh Nadeem (N)

Zaed Hamady (Z)

Shoura Karar (S)

Ali Arshad (A)

Bilal Al-Sarrieh (B)

Adam Yarwood (A)

Mohammed Hammoda (M)

Alejandro Serrablo (A)

Maria Artigas (M)

Sandra Paterna-López (S)