Detrimental Effect of Postoperative Complications on Oncologic Efficacy of R0 Pancreatectomy in Ductal Adenocarcinoma of the Pancreas
- 160 Downloads
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.
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].
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.
KeywordsPancreatic cancer Complication R0 Pancreatectomy Survival
- 3.Yeo CJ, Cameron JL, Sohn TA, et al. Pancreaticoduodenectomy with or without extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma: comparison of morbidity and mortality and short-term outcome. Ann Surg 1999;229(5):613–622. (discussion 622–624). doi: 10.1097/00000658-199905000-00003.PubMedCrossRefGoogle Scholar
- 20.Howard TJ, Krug JE, Yu J, et al. A margin-negative R0 resection accomplished with minimal postoperative complications is the surgeon's contribution to long-term survival in pancreatic cancer. J Gastrointest Surg 2006;10(10):1338–1345. (discussion 1345–1346) doi: 10.1016/j.gassur.2006.09.008.PubMedCrossRefGoogle Scholar
- 22.Greene FL, Page DL, Fleming ID, et al. AJCC Cancer Staging Manual. 6th ed. Philadelphia: Lippincott-Raven.Google Scholar