Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas

Chang Moo Kang, Dong Hyun Kim, Gi Hong Choi, Kyung Sik Kim, Jin Sub Choi, Woo Jung Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: 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. Results: 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]. Conclusion: 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.

Original languageEnglish
Pages (from-to)907-914
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume13
Issue number5
DOIs
Publication statusPublished - 2009 May 1

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Pancreatectomy
Pancreas
Adenocarcinoma
Pancreatic Neoplasms
Survival
Medical Records
Multivariate Analysis
Observation
Morbidity
Margins of Excision
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Kang, Chang Moo ; Kim, Dong Hyun ; Choi, Gi Hong ; Kim, Kyung Sik ; Choi, Jin Sub ; Lee, Woo Jung. / Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas. In: Journal of Gastrointestinal Surgery. 2009 ; Vol. 13, No. 5. pp. 907-914.
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abstract = "Background: 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. Results: 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]. Conclusion: 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.",
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Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas. / Kang, Chang Moo; Kim, Dong Hyun; Choi, Gi Hong; Kim, Kyung Sik; Choi, Jin Sub; Lee, Woo Jung.

In: Journal of Gastrointestinal Surgery, Vol. 13, No. 5, 01.05.2009, p. 907-914.

Research output: Contribution to journalArticle

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AU - Kang, Chang Moo

AU - Kim, Dong Hyun

AU - Choi, Gi Hong

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AU - Choi, Jin Sub

AU - Lee, Woo Jung

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N2 - Background: 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. Results: 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]. Conclusion: 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.

AB - Background: 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. Results: 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]. Conclusion: 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.

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