Morbidity among long-term survivors after pancreatoduodenectomy for pancreatic adenocarcinoma.

Abstract

BACKGROUND:

Because pancreatoduodenectomy for pancreatic adenocarcinoma is focused on disease-free and overall survival, morbidity among long-term survivors is not well described. This study sought to evaluate outcomes for long-term survivors of pancreatic cancer after pancreatoduodenectomy.

METHODS:

The authors identified 29 patients from their prospectively collected database of patients with pancreatic adenocarcinoma who had undergone pancreatoduodenectomy and were without evidence of disease during at least 3 years of follow-up evaluation. Demographics, treatment, and pathologic characteristics were collected for review. Data with regard to long-term sequelae also were collected, focusing on those complications requiring additional procedures and on the development of metachronous cancers.

RESULTS:

The median follow-up period was 83 months, with 62 % of patients still alive. All patients received an R0 resection, and 34 % of the patients had N1 disease. For 42 % of the patients, no significant subsequent sequelae occurred. In the four remaining patients (14 %), ascites developed, requiring repeated paracentesis or Denver shunt, with a median time to development (MTD) of 63 months. Six patients (21 %) experienced a biliary stricture requiring stent placement (MTD, 56 months). One patient experienced portal venous thrombosis requiring a venous stent (MTD, 52 months), and four patients (14 %) experienced clinically significant ulcers (MTD, 52 months). With regard to metachronous cancers, two patients experienced subsequent lymphomas (MTD, 92 months).

CONCLUSIONS:

Long-term survivors among patients who undergo pancreatoduodenectomy for pancreatic adenocarcinoma can experience significant late sequelae, which often manifest more than 3 years after surgery. As such, continued follow-up evaluation and counseling are warranted.

• Authors: Kathryn T Chen, Karthik Devarajan, John P Hoffman
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 22 Issue 4 Pg. 1185-9 (Apr 2015) ISSN: 1534-4681 [Electronic] United States
• PMID: 25384699 (Publication Type: Journal Article)

Topics

• Adenocarcinoma (mortality, pathology, surgery)
• Aged
• Female
• Follow-Up Studies
• Humans
• Male
• Morbidity
• Neoplasm Recurrence, Local (mortality, pathology, surgery)
• Neoplasm Staging
• Pancreatic Neoplasms (mortality, pathology, surgery)
• Pancreaticoduodenectomy (mortality)
• Postoperative Complications
• Prognosis
• Prospective Studies
• Survival Rate
• Survivors