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Effect of postoperative major complications on prognosis after pancreatectomy for pancreatic cancer: a retrospective review

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Abstract

Purpose

To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer.

Methods

We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien–Dindo classification.

Results

Thirty-eight patients (31 %) suffered major postoperative complications and 40 patients (33 %) suffered minor complications only. Univariate survival analysis showed that patients with major complications had a significantly worse prognosis than those without major complications, with regard to recurrence-free survival (RFS) (P < 0.01) and overall survival (OS) (P < 0.01), whereas minor complications did not affect survival. Major complications significantly inhibited or delayed adjuvant chemotherapy. Multivariate survival analysis showed that the absence of postoperative major complications was an independent favorable factor for RFS (hazard ratio 0.48; 95 % confidence interval: 0.28–0.85) and OS (hazard ratio 0.47; 95 % confidence interval 0.27–0.81).

Conclusions

Postoperative major complications after pancreatectomy for pancreatic cancer affect the prognosis.

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Authors and Affiliations

  1. Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan

    Yusuke Watanabe, Kazuyoshi Nishihara, Sokichi Matsumoto, Takafumi Okayama, Yuji Abe & Toru Nakano

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  1. Yusuke Watanabe
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  2. Kazuyoshi Nishihara
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  3. Sokichi Matsumoto
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  4. Takafumi Okayama
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  6. Toru Nakano
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Correspondence to Yusuke Watanabe.

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Watanabe, Y., Nishihara, K., Matsumoto, S. et al. Effect of postoperative major complications on prognosis after pancreatectomy for pancreatic cancer: a retrospective review. Surg Today 47, 555–567 (2017). https://doi.org/10.1007/s00595-016-1426-1

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  • DOI: https://doi.org/10.1007/s00595-016-1426-1

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