Long-term survival following radical surgery for pancreatic adenocarcinoma in a high-complexity Latin American center
DOI:
https://doi.org/10.30944/20117582.3141Palabras clave:
pancreatic neoplasms, pancreatectomy, pancreaticoduodenectomy, survival, mortality, risk factorsResumen
Introduction. Pancreatic cancer remains one of the deadliest malignancies worldwide, with limited long-term survival. Surgical resection continues to be the primary curative option for pancreatic adenocarcinoma. This study aimed to assess intraoperative and postoperative associated with long-term survival following radical pancreatic cancer surgery.
Methods. A single-center cohort survival analysis was conducted including patients who underwent radical surgery for pancreatic adenocarcinoma between 2006 and 2019 at a high-complexity institution. Factors such as factors type of surgery, operative time, intraoperative blood loss, macroscopic pancreatic features, histopathological findings, and postoperative complications were included.
Results. A total of 118 pancreatic adenocarcinoma resections were analyzed. Thirty-day mortality was 4.2%, occurring exclusively in the Whipple group. Actuarial survival reached 10.6%, while at 1-year and 5-year survival rates were 67.8% and 12.1%, respectively. Survival was negatively affected by lymphovascular invasion (HR 1.52; 95% CI 1.009–2.314), positive resection margins (HR 1.73; 95% CI 1.091–2.773), lymph-node resection ratio ≥0.3 (HR 1.52; 95% CI 1.656–4.823), preoperative CA 19–9 ≥ 400 U/ml (HR 1.52; 95% CI 1.007–2.372), and transfusion requirements (HR 1.52; 95% CI 1.097–2.825).
Conclusion. The long-term survival after radical surgery for pancreatic adenocarcinoma is influenced by several modifiable factors.
Descargas
Referencias bibliográficas
Torphy RJ, Fujiwara Y, Schulick RD. Pancreatic cancer treatment: better, but a long way to go. Surg Today. 2020;50:1117-25. https://doi.org/10.1007/s00595-020-02028-0
Sun R, Yu J, Zhang Y, Liang Z, Han X. Perioperative and oncological outcomes following minimally invasive versus open pancreaticoduodenectomy for pancreatic duct adenocarcinoma. Surg Endosc. 2021;35:2273-85. https://doi.org/10.1007/s00464-020-07641-1
Jia X, Du P, Wu K, Xu Z, Fang J, Xu X, et al. Pancreatic cancer mortality in China: Characteristics and prediction. Pancreas. 2018;47:233-7. https://doi.org/10.1097/MPA.0000000000000976
McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018;24:4846-61. https://doi.org/10.3748/wjg.v24.i43.4846
Zhang L, Sanagapalli S, Stoita A. Challenges in diagnosis of pancreatic cancer. World J Gastroenterol. 2018;24:2047-60. https://doi.org/10.3748/wjg.v24.i19.2047
Aziz AM, Abbas A, Gad H, Al-Saif OH, Leung K, Meshikhes AW. Pancreaticoduodenectomy in a tertiary referral center in Saudi Arabia: A retrospective case series. J Egypt Natl Canc Inst. 2012;24:47-54. https://doi.org/10.1016/j.jnci.2011.12.007
Distler M, Rückert F, Hunger M, Kersting S, Pilarsky C, Saeger HD, et al. Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma. BMC Surg. 2013;13:12. https://doi.org/10.1186/1471-2482-13-12
Schneider M, Hackert T, Strobel O, Büchler MW. Technical advances in surgery for pancreatic cancer. Br J Surg. 2021;108:777-85. https://doi.org/10.1093/bjs/znab133
Strobel O, Neoptolemos J, Jäger D, Büchler MW. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol. 2019;16:11-26. https://doi.org/10.1038/s41571-018-0112-1
Franko J, Hugec V, Lopes TL, Goldman CD. Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm. Ann Surg Oncol. 2013;20:357-61. https://doi.org/10.1245/s10434-012-2621-y
Malleo G, Marchegiani G, Salvia R, Butturini G, Pederzoli P, Bassi C. Pancreaticoduodenectomy for pancreatic cancer: The Verona experience. Surg Today. 2011;41:463-70. https://doi.org/10.1007/s00595-010-4419-5
Masiak-Segit W, Rawicz-Pruszyński K, Skórzewska M, Polkowski WP. Surgical treatment of pancreatic cancer. Pol Przegl Chir. 2018;90:45-53. https://doi.org/10.5604/01.3001.0011.7493
Lewis R, Drebin JA, Callery MP, Fraker D, Kent TS, Gates J, et al. A contemporary analysis of survival for resected pancreatic ductal adenocarcinoma. HPB (Oxford). 2013;15:49-60. https://doi.org/10.1111/j.1477-2574.2012.00571.x
Pugalenthi A, Protic M, Gonen M, Kingham TP, Angelica MI, Dematteo RP, et al. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016;113:188-93. https://doi.org/10.1002/jso.24125
Norero E, Viñuela E, Báez S, Martínez C, Reyes J, Kusanovic R, et al. Results of pancreaticoduodenectomy in the treatment of periampullary tumors. Rev Med Chil. 2011;139:1015-24. https://doi.org/10.4067/S0034-98872011000800006
Chávez J, Hoyos S, Duarte Á, Ángel C, Segura Á. Análisis de la mortalidad posoperatoria temprana en una cohorte de 132 pacientes sometidos a cirugía de Whipple en Medellín. Rev Colomb Cir. 2014;29:123-30. https://doi.org/10.30944/20117582.410
Oguro S, Shimada K, Kishi Y, Nara S, Esaki M, Kosuge T. Perioperative and long-term outcomes after pancreaticoduodenectomy in elderly patients 80 years of age and older. Langenbecks Arch Surg. 2013;398:531-8. https://doi.org/10.1007/s00423-013-1072-7
Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery. 2017;161:584-91. https://doi:10.1016/j.surg.2016.11.014
Karunakaran M, Barreto SG. Surgery for pancreatic cancer: current controversies and challenges. Future Oncol. 2021;17:5135-62. https://doi.org/10.2217/fon-2021-0533
Zhao Z, Liu W. Pancreatic Cancer: A review of risk factors, diagnosis, and treatment. Technol Cancer Res Treat. 2020;19:1533033820962117. https://doi.org/10.1177/1533033820962117
Cai J, Chen H, Lu M, Zhang Y, Lu B, You L, et al. Advances in the epidemiology of pancreatic cancer: Trends, risk factors, screening, and prognosis. Cancer Lett. 2021;520:1-11. https://doi.org/10.1016/j.canlet.2021.06.027
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Revista Colombiana de Cirugía
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Todos los textos incluidos en la Revista Colombiana de Cirugía están protegidos por derechos de autor. Las opiniones expresadas en los artículos firmados son las de los autores y no coinciden necesariamente con las de los directores o los editores de la Revista Colombiana de Cirugía. Las sugerencias diagnósticas o terapéuticas como elección de productos, dosificación y métodos de empleo corresponden a la experiencia y al criterio de los autores.
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |
.jpg)
