The 1-year disease-related mortality after resection for pancreatic cancer is approximately 30\%. This study examined potential preoperative parameters that would help avoid unnecessary surgery.Among the patients resected at our institution from 1997 to 2006, a total of 228 underwent pancreatic resection for ductal adenocarcinoma. By means of a survival cutoff of 12 months, two groups were created: early death (ED) and long survivors. A logistic regression analysis was performed to identify perioperative predictors of ED.Among 228 resected patients, postoperative mortality occurred in four cases (1.8\%) that were excluded from the study. In the remaining 224 patients, 43 (19.2\%) died of disease within 12 months from surgery (ED), and the remaining 181 (80.8\%) had a longer survival. Multivariate analysis selected duration of preoperative symptoms > 40 days, CA 19-9 > 200 U/mL, pathological grading G3-G4, and R2 resection as independent predictors of ED.Duration of symptoms, CA 19-9 serum level, and pathological grading possibly retrieved by endoscopic ultrasound-guided biopsy can be preoperatively used to identify patients with disease that is not suitable for up-front surgery, even if deemed resectable by high-quality imaging.

Resectable pancreatic cancer: who really benefits from resection?

BARUGOLA, Giuliano;Capelli, Paola;BASSI, Claudio;PEDERZOLI, Paolo;FALCONI, Massimo
2009-01-01

Abstract

The 1-year disease-related mortality after resection for pancreatic cancer is approximately 30\%. This study examined potential preoperative parameters that would help avoid unnecessary surgery.Among the patients resected at our institution from 1997 to 2006, a total of 228 underwent pancreatic resection for ductal adenocarcinoma. By means of a survival cutoff of 12 months, two groups were created: early death (ED) and long survivors. A logistic regression analysis was performed to identify perioperative predictors of ED.Among 228 resected patients, postoperative mortality occurred in four cases (1.8\%) that were excluded from the study. In the remaining 224 patients, 43 (19.2\%) died of disease within 12 months from surgery (ED), and the remaining 181 (80.8\%) had a longer survival. Multivariate analysis selected duration of preoperative symptoms > 40 days, CA 19-9 > 200 U/mL, pathological grading G3-G4, and R2 resection as independent predictors of ED.Duration of symptoms, CA 19-9 serum level, and pathological grading possibly retrieved by endoscopic ultrasound-guided biopsy can be preoperatively used to identify patients with disease that is not suitable for up-front surgery, even if deemed resectable by high-quality imaging.
2009
Aged; Carcinoma; Pancreatic Ductal; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence; Local; Neoplasm Staging; Pancreatectomy; Pancreatic Neoplasms; Perioperative Care; Prognosis; Survival Rate; Treatment Outcome
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/353246
Citazioni
  • ???jsp.display-item.citation.pmc??? 55
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact