Abstract | HYPOTHESIS: DESIGN: Retrospective case series. SETTING: Major academic medical and pancreatic surgery center. PATIENTS: A total of 182 consecutive patients underwent pancreaticoduodenectomy for various diagnoses between 1987 and 2005. Patients from 1987-1995 were compared with patients from 1996-2005. INTERVENTIONS: MAIN OUTCOME MEASURES: RESULTS: During the time period analyzed, 182 patients underwent pancreaticoduodenectomy to treat ductal adenocarcinoma. There were no operative deaths, and 86.3% of patients had an R0 resection. The 5-year survival rate for the entire group was 27.4%. However, survival improved from 15.8% to 35.5% during the study period. Both groups had equivalent demographic and pathological characteristics, and the only predictors of poor survival in multivariate analysis were operative blood loss of more than 400 mL (hazard ratio, 2.17), poorly differentiated tumors (3.03), lymph node metastases (1.92), perineural invasion (2.66), and undergoing an operation before 1996 (1.42). CONCLUSIONS: The survival rate for patients undergoing pancreaticoduodenectomy to treat pancreatic cancer has substantially improved. This finding is partially owing to improved operative technique and limited operative blood loss.
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Authors | Kevork K Kazanjian, O Joe Hines, John P Duffy, Diana Y Yoon, Galen Cortina, Howard A Reber |
Journal | Archives of surgery (Chicago, Ill. : 1960)
(Arch Surg)
Vol. 143
Issue 12
Pg. 1166-71
(Dec 2008)
ISSN: 1538-3644 [Electronic] United States |
PMID | 19075167
(Publication Type: Journal Article)
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Topics |
- Adenocarcinoma
(pathology, surgery)
- Aged
- Blood Loss, Surgical
(mortality)
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Pancreatic Neoplasms
(pathology, surgery)
- Pancreaticoduodenectomy
(mortality)
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
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