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Detrimental Effect of Postoperative Complications on Oncologic Efficacy of R0 Pancreatectomy in Ductal Adenocarcinoma of the Pancreas

  • Chang Moo Kang
  • Dong Hyun Kim
  • Gi Hong Choi
  • Kyung Sik Kim
  • Jin Sub Choi
  • Woo Jung LeeEmail author
Original Article

Abstract

Background

Margin-negative resection of pancreatic cancers has proven to be the most effective treatment to date. Although there are frequent surgery-related complications following pancreatectomy, the oncologic effect of these complications following pancreatectomy for pancreatic cancer has not been studied.

Materials and Methods

Retrospective observation of medical records of resected pancreatic ductal adenocarcinoma performed from January 1990 to June 2006 was used in this study. Potentially curative surgical resections of pancreatic ductal adenocarcinoma were performed on 103 patients. Survival was analyzed according to various clinicopathologic variables.

Results

Negative surgical margins (p = 0.0075) and absence of postoperative major complications related to surgery (p = 0.0116) were all significantly favorable prognostic factors in both univariate and multivariate analysis. Margin-negative pancreatectomy without major complications showed the most favorable oncologic outcomes in resected pancreatic cancer (median survival, 35.6 months; 95% confidential interval, 25.8–45.4 months), while major morbidities diminished survival benefit of R0 resection [R0-Cx(+), Exp(β) = 1.925, p = 0.034, and R1, Exp(β) = 3.129, p = 0.001].

Conclusion

Surgery-related major complication diminished the oncologic efficacy of R0 pancreatectomy. Margin-negative resection without major complication can enhance postoperative oncologic outcomes in ductal adenocarcinoma of the pancreas.

Keywords

Pancreatic cancer Complication R0 Pancreatectomy Survival 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2009

Authors and Affiliations

  • Chang Moo Kang
    • 1
    • 2
  • Dong Hyun Kim
    • 1
    • 2
  • Gi Hong Choi
    • 1
    • 2
  • Kyung Sik Kim
    • 1
    • 2
  • Jin Sub Choi
    • 1
    • 2
  • Woo Jung Lee
    • 1
    • 2
    Email author
  1. 1.Department of SurgeryYonsei University College of MedicineSeoulKorea
  2. 2.Institute of GastroenterologyYonsei University Health SystemSeoulKorea

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