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Recurrence Pattern and Prognosis of Pancreatic Cancer After Pancreatic Fistula

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The negative impact of anastomotic leakage on cancer-specific survival and recurrence patterns has been recognized in colorectal cancer. In pancreatic cancer, pancreatic fistula (PF) is a serious morbidity, but its negative effect on long-term outcome remains to be elucidated. The aim of this study was to determine the impact of PF on pancreatic cancer recurrence.

Methods

The medical records of 184 patients with curative pancreatectomy for pancreatic cancer were reviewed. PF was scored on the basis of the International Study Group of Pancreatic Fistula classification. Overall and disease-free survivals and recurrence patterns were analyzed. Grade A PF was excluded because the negative effects can be negligible.

Results

PF occurred in 51 of the 184 patients (27.7%). The mortality related to PF was 0.5% (1 of 184). PF was an independent risk factor for peritoneal recurrence (hazard ratio 3.974; 95% confidence interval 1.345–11.737; P = 0.013). According to the analysis of disease-free survival in patients with peritoneal recurrence, time to recurrence was shorter and the survival rate was worse in patients with PF than in those without PF (5.6 vs. 8.2 months; 6-month survival, 40 vs. 71%; 1-year survival, 7 vs. 19%; P = 0.053). PF was an independent prognostic factor after multivariate analysis (hazard ratio 3.257; 95% confidence interval 1.201–8.828; P = 0.020).

Conclusions

PF was statistically significantly related to peritoneal recurrence, and patients with PF developed peritoneal recurrence earlier than those without PF. With regard to the development of peritoneal recurrence, PF may be considered to be a negative prognostic factor.

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Authors and Affiliations

  1. Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Shunji Nagai MD, PhD, Tsutomu Fujii MD, PhD, FACS, Yasuhiro Kodera MD, PhD, FACS, Mitsuro Kanda MD, PhD, Tevfik T. Sahin MD, Akiyuki Kanzaki MD, Masamichi Hayashi MD, Hiroyuki Sugimoto MD, PhD, Shuji Nomoto MD, PhD, Shin Takeda MD, PhD & Akimasa Nakao MD, PhD, FACS

  2. Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan

    Satoshi Morita PhD

Authors
  1. Shunji Nagai MD, PhD
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  2. Tsutomu Fujii MD, PhD, FACS
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  3. Yasuhiro Kodera MD, PhD, FACS
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  4. Mitsuro Kanda MD, PhD
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  5. Tevfik T. Sahin MD
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  6. Akiyuki Kanzaki MD
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  7. Masamichi Hayashi MD
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  8. Hiroyuki Sugimoto MD, PhD
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  9. Shuji Nomoto MD, PhD
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  10. Shin Takeda MD, PhD
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  11. Satoshi Morita PhD
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  12. Akimasa Nakao MD, PhD, FACS
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Corresponding author

Correspondence to Tsutomu Fujii MD, PhD, FACS.

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Nagai, S., Fujii, T., Kodera, Y. et al. Recurrence Pattern and Prognosis of Pancreatic Cancer After Pancreatic Fistula. Ann Surg Oncol 18, 2329–2337 (2011). https://doi.org/10.1245/s10434-011-1604-8

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  • DOI: https://doi.org/10.1245/s10434-011-1604-8

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