BACKGROUND: High-volume centers have to deal with long surgical waiting-lists leading to a potential delay in treatment. This study assessed whether a longer time from diagnosis to surgery worsened pathological and survival outcomes in resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A retrospective analysis of patients treated for resectable PDAC. Difference in size between preoperative CT-scan and specimen, pathological features, the rate of vascular and R1 resections as well as recurrence and survival were analyzed depending on the waiting time using a 30-day cut-off. RESULTS: Waiting more than 30 days for surgery was associated with an increase in tumor size on specimen when compared with CT-scan (+3 vs. +1 mm, p = 0.04). T and N status, rate of vascular resection, grading, perineural and lymphovascular infiltration, and R1 rates did not differ between groups, as well as tumor recurrence (48.8% vs. 48.9%, p = 0.5) and survival (31 vs. 29 months, p = 0.7). For PDAC < 20 mm, waiting less than 30 days improved overall survival (p = 0.02). CONCLUSION: The duration of the surgical waiting-list did not affect pathological features and survival. Delayed surgery was associated with increased cancer size on the specimen. However, surgery should not be delayed for PDACs < 20 mm as this may negatively affect the prognosis.
BACKGROUND: High-volume centers have to deal with long surgical waiting-lists leading to a potential delay in treatment. This study assessed whether a longer time from diagnosis to surgery worsened pathological and survival outcomes in resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A retrospective analysis of patients treated for resectable PDAC. Difference in size between preoperative CT-scan and specimen, pathological features, the rate of vascular and R1 resections as well as recurrence and survival were analyzed depending on the waiting time using a 30-day cut-off. RESULTS: Waiting more than 30 days for surgery was associated with an increase in tumor size on specimen when compared with CT-scan (+3 vs. +1 mm, p = 0.04). T and N status, rate of vascular resection, grading, perineural and lymphovascular infiltration, and R1 rates did not differ between groups, as well as tumor recurrence (48.8% vs. 48.9%, p = 0.5) and survival (31 vs. 29 months, p = 0.7). For PDAC < 20 mm, waiting less than 30 days improved overall survival (p = 0.02). CONCLUSION: The duration of the surgical waiting-list did not affect pathological features and survival. Delayed surgery was associated with increased cancer size on the specimen. However, surgery should not be delayed for PDACs < 20 mm as this may negatively affect the prognosis.
Authors: Scott C Fligor; Sophie Wang; Benjamin G Allar; Savas T Tsikis; Ana Sofia Ore; Ashlyn E Whitlock; Rodrigo Calvillo-Ortiz; Kevin R Arndt; Sidhu P Gangadharan; Mark P Callery Journal: J Gastrointest Surg Date: 2020-06-30 Impact factor: 3.452
Authors: R Pandé; J Hodson; A Murray; F Marcon; M Kalisvaart; R Marudanayagam; R P Sutcliffe; D F Mirza; J Isaac; K J Roberts Journal: BJS Open Date: 2019-04-02
Authors: M W Steen; L B van Rijssen; S Festen; O R Busch; B Groot Koerkamp; L G van der Geest; I H de Hingh; H C van Santvoort; M G Besselink; M F Gerhards Journal: BJS Open Date: 2020-08-25
Authors: R Casolino; C Braconi; G Malleo; S Paiella; C Bassi; M Milella; S B Dreyer; F E M Froeling; D K Chang; A V Biankin; T Golan Journal: Ann Oncol Date: 2020-11-26 Impact factor: 32.976
Authors: M Brugel; O Bouché; R Kianmanesh; L Teuma; A Tashkandi; J M Regimbeau; P Pessaux; B Royer; R Rhaiem; C Perrenot; C Neuzillet; T Piardi; S Deguelte Journal: BMC Surg Date: 2021-12-07 Impact factor: 2.102
Authors: Denise Garcia; Julie B Siegel; David A Mahvi; Biqi Zhang; David M Mahvi; E Ramsay Camp; Whitney Graybill; Stephen J Savage; Antonio Giordano; Sara Giordano; Denise Carneiro-Pla; Mahsa Javid; Aaron P Lesher; Andrea Abbott; Nancy Klauber DeMore Journal: Clin Oncol Res Date: 2020-06-26