Yusuke Watanabe1, Kazuyoshi Nishihara2, Sokichi Matsumoto2, Takafumi Okayama2, Yuji Abe2, Toru Nakano2. 1. Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan. wyuusuke@surg1.med.kyushu-u.ac.jp. 2. Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
Abstract
PURPOSE: To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer. METHODS: We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien-Dindo classification. RESULTS: Thirty-eight patients (31 %) suffered major postoperative complications and 40 patients (33 %) suffered minor complications only. Univariate survival analysis showed that patients with major complications had a significantly worse prognosis than those without major complications, with regard to recurrence-free survival (RFS) (P < 0.01) and overall survival (OS) (P < 0.01), whereas minor complications did not affect survival. Major complications significantly inhibited or delayed adjuvant chemotherapy. Multivariate survival analysis showed that the absence of postoperative major complications was an independent favorable factor for RFS (hazard ratio 0.48; 95 % confidence interval: 0.28-0.85) and OS (hazard ratio 0.47; 95 % confidence interval 0.27-0.81). CONCLUSIONS: Postoperative major complications after pancreatectomy for pancreatic cancer affect the prognosis.
PURPOSE: To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer. METHODS: We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien-Dindo classification. RESULTS: Thirty-eight patients (31 %) suffered major postoperative complications and 40 patients (33 %) suffered minor complications only. Univariate survival analysis showed that patients with major complications had a significantly worse prognosis than those without major complications, with regard to recurrence-free survival (RFS) (P < 0.01) and overall survival (OS) (P < 0.01), whereas minor complications did not affect survival. Major complications significantly inhibited or delayed adjuvant chemotherapy. Multivariate survival analysis showed that the absence of postoperative major complications was an independent favorable factor for RFS (hazard ratio 0.48; 95 % confidence interval: 0.28-0.85) and OS (hazard ratio 0.47; 95 % confidence interval 0.27-0.81). CONCLUSIONS: Postoperative major complications after pancreatectomy for pancreatic cancer affect the prognosis.
Authors: James F Helm; Barbara A Centeno; Domenico Coppola; Mihaela Druta; Jong Y Park; Dung-Tsa Chen; Pamela J Hodul; Larry K Kvols; Timothy J Yeatman; Larry C Carey; Richard C Karl; Mokenge P Malafa Journal: Cancer Control Date: 2008-10 Impact factor: 3.302
Authors: C J Yeo; J L Cameron; K D Lillemoe; J V Sitzmann; R H Hruban; S N Goodman; W C Dooley; J Coleman; H A Pitt Journal: Ann Surg Date: 1995-06 Impact factor: 12.969
Authors: Toni Lerut; Johnny Moons; Willy Coosemans; Dirk Van Raemdonck; Paul De Leyn; Herbert Decaluwé; Georges Decker; Philippe Nafteux Journal: Ann Surg Date: 2009-11 Impact factor: 12.969
Authors: Hari Nathan; Christopher L Wolfgang; Barish H Edil; Michael A Choti; Joseph M Herman; Richard D Schulick; John L Cameron; Timothy M Pawlik Journal: J Surg Oncol Date: 2009-02-01 Impact factor: 3.454
Authors: Juan W Valle; Daniel Palmer; Richard Jackson; Trevor Cox; John P Neoptolemos; Paula Ghaneh; Charlotte L Rawcliffe; Claudio Bassi; Deborah D Stocken; David Cunningham; Derek O'Reilly; David Goldstein; Bridget A Robinson; Christos Karapetis; Andrew Scarfe; Francois Lacaine; Juhani Sand; Jakob R Izbicki; Julia Mayerle; Christos Dervenis; Attila Oláh; Giovanni Butturini; Pehr A Lind; Mark R Middleton; Alan Anthoney; Kate Sumpter; Ross Carter; Markus W Büchler Journal: J Clin Oncol Date: 2014-01-13 Impact factor: 44.544
Authors: F Jasmijn Smits; Anne Claire Henry; Casper H van Eijck; Marc G Besselink; Olivier R Busch; Mark Arntz; Thomas L Bollen; Otto M van Delden; Daniel van den Heuvel; Christiaan van der Leij; Krijn P van Lienden; Adriaan Moelker; Bert A Bonsing; Inne H M Borel Rinkes; Koop Bosscha; R M van Dam; Sebastiaan Festen; B Groot Koerkamp; Erwin van der Harst; Ignace H de Hingh; Geert Kazemier; Mike Liem; B Marion van der Kolk; Vincent E de Meijer; Gijs A Patijn; Daphne Roos; Jennifer M Schreinemakers; Fennie Wit; C Henri van Werkhoven; I Quintus Molenaar; Hjalmar C van Santvoort Journal: Trials Date: 2020-05-07 Impact factor: 2.279