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Preoperative Chemotherapy Does Not Adversely Affect Pancreatic Structure and Short-Term Outcome after Pancreatectomy

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Preoperative chemotherapy (PCHT) has recently been proposed also in patients with resectable pancreatic adenocarcinoma. Few data are currently available on the impact of PCHT on short-term postoperative outcome after pancreatic resection. The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection.

Methods

Fifty consecutive patients successfully underwent resection after PCHT. Each patient was matched with two control patients with pancreatic adenocarcinoma selected from our prospective electronic database. Match criteria were age (±3 years), gender, American Society of Anesthesiologist score, type of resection, pancreatic duct diameter (±1 mm), and tumor size (±5 mm). Primary endpoint was morbidity rate. Secondary endpoints were pancreatic parenchymal structure, mortality rate, and length of hospital stay (LOS).

Results

Both degree of fibrosis and fatty infiltration of the pancreas were similar in the two groups. Overall morbidity rate was 48.0 % in the PCHT group vs. 54.0 % in the control group (p = 0.37). Pancreatic fistula rate was 18.0 % in the PCHT group vs. 25.0 % in the control group (p = 0.41). Mortality was 4.0 % in the PCHT group vs. 2.0 % in the control group (p = 0.60). Mean LOS (days) was 12.7 in the PCHT group vs. 12.4 in the control group (p = 0.74). There was no difference in resection margin status, while the rate of patients without nodal involvement was higher in the PCHT group (46.0 vs. 23.0 %, p = 0.004).

Conclusion

PCHT did not induce significant structural changes in pancreatic parenchyma and did not adversely affect short-term outcome after surgery.

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Conflict of Interest

All the authors of the present manuscript Nicolò Pecorelli M.D., Marco Braga M.D., Claudio Doglioni M.D., Gianpaolo Balzano M.D., Michele Reni M.D., Stefano Cereda M.D., Luca Albarello M.D., Renato Castoldi M.D., Giovanni Capretti M.D., and Valerio Di Carlo M.D. have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Nicolò Pecorelli, Marco Braga, Gianpaolo Balzano, Renato Castoldi, Giovanni Capretti & Valerio Di Carlo

  2. Department of Pathology, Vita-Salute San Raffaele University, Milan, Italy

    Claudio Doglioni & Luca Albarello

  3. Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy

    Michele Reni & Stefano Cereda

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  1. Nicolò Pecorelli
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  2. Marco Braga
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  3. Claudio Doglioni
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  4. Gianpaolo Balzano
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  5. Michele Reni
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  6. Stefano Cereda
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  7. Luca Albarello
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  8. Renato Castoldi
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  9. Giovanni Capretti
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  10. Valerio Di Carlo
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Correspondence to Marco Braga.

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Pecorelli, N., Braga, M., Doglioni, C. et al. Preoperative Chemotherapy Does Not Adversely Affect Pancreatic Structure and Short-Term Outcome after Pancreatectomy. J Gastrointest Surg 17, 488–493 (2013). https://doi.org/10.1007/s11605-012-2063-7

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  • DOI: https://doi.org/10.1007/s11605-012-2063-7

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