Improved Long-Term Outcomes After Resection of Pancreatic Adenocarcinoma: A Comparison Between Two Time Periods

Background Despite reduced perioperative mortality and routine use of adjuvant therapy following pancreatectomy for pancreatic ductal adenocarcinoma (PDAC), improvement in long-term outcome has been difficult to ascertain. This study compares outcomes in patients undergoing resection for PDAC within...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-04, Vol.22 (4), p.1160-1167
Main Authors: Serrano, Pablo E., Cleary, Sean P., Dhani, Neesha, Kim, Peter T. W., Greig, Paul D., Leung, Kenneth, Moulton, Carol-Anne, Gallinger, Steven, Wei, Alice C.
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal - mortality
Carcinoma, Pancreatic Ductal - pathology
Carcinoma, Pancreatic Ductal - surgery
Female
Follow-Up Studies
Humans
Lymph Nodes - pathology
Lymph Nodes - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Oncology
Pancreatectomy - mortality
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Pancreatic Tumors
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
Time Factors
Young Adult
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Summary:Background Despite reduced perioperative mortality and routine use of adjuvant therapy following pancreatectomy for pancreatic ductal adenocarcinoma (PDAC), improvement in long-term outcome has been difficult to ascertain. This study compares outcomes in patients undergoing resection for PDAC within a single, high-volume academic institution over two sequential time periods. Methods Retrospective review of patients with resected PDAC, in two cohorts: period 1 (P1), 1991–2000; and period 2 (P2), 2001–2010. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine prognostic factors associated with long-term survival. Survival was evaluated using Kaplan–Meier analyses. Results A total of 179 pancreatectomies were performed during P1 and 310 during P2. Perioperative mortality was 6.7 % (12/179) in P1 and 1.6 % (5/310) in P2 ( p  = 0.003). P2 had a greater number of lymph nodes resected (17 [0–50] vs. 7 [0–31]; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-014-4196-2