Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Marius Distler - , Department of Visceral, Thoracic and Vascular Surgery, National Center for Tumor Diseases (Partners: UKD, MFD, HZDR, DKFZ), University Hospital Carl Gustav Carus Dresden (Author)
  • Felix Rückert - , Heidelberg University  (Author)
  • Maximilian Hunger - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Stephan Kersting - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Christian Pilarsky - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Hans Detlev Saeger - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Robert Grützmann - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)

Abstract

Background: Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma (PDAC). The goal of this study was to investigate the clinical outcome and prognostic factors in patients after resection for ductal adenocarcinoma of the pancreatic head. Methods. The data from 195 patients who underwent pancreatic head resection for PDAC between 1993 and 2011 in our center were retrospectively analyzed. The prognostic factors for survival after operation were evaluated using multivariate analysis. Results: The head resection surgeries included 69.7% pylorus-preserving pancreatoduodenectomies (PPPD) and 30.3% standard Kausch-Whipple pancreatoduodenectomies (Whipple). The overall mortality after pancreatoduodenectomy (PD) was 4.1%, and the overall morbidity was 42%. The actuarial 3- and 5-year survival rates were 31.5% (95% CI, 25.04%-39.6%) and 11.86% (95% CI, 7.38%-19.0%), respectively. Univariate analyses demonstrated that elevated CEA (p = 0.002) and elevated CA 19-9 (p = 0.026) levels, tumor grade (p = 0.001) and hard texture of the pancreatic gland (p = 0.017) were significant predictors of a poor survival. However, only CEA >3 ng/ml (p < 0.005) and tumor grade 3 (p = 0.027) were validated as significant predictors of survival in multivariate analysis. Conclusions: Our results suggest that tumor marker levels and tumor grade are significant predictors of poor survival for patients with pancreatic head cancer. Furthermore, hard texture of the pancreatic gland appears to be associated with poor survival.

Details

Original languageEnglish
Article number12
JournalBMC surgery
Volume13
Issue number1
Publication statusPublished - 2013
Peer-reviewedYes

External IDs

PubMed 23607915

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Pancreatic cancer, Pylorus-preserving pancreatoduodenectomy (PPPD), Surgery, Tumor marker, Whipple procedure