Laëtitia Courtin-Tanguy1, Olivier Turrini2, Damien Bergeat3, Stéphanie Truant4, Benjamin Darnis5, Jean R Delpero6, Jean Y Mabrut5, Nicolas Regenet7, Laurent Sulpice8. 1. CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive, Rennes, France; Université Rennes1, Faculté de Médecine, Rennes, France; INSERM U991, Foie Métabolismes et Cancer, Rennes, France. 2. Institut Paoli-Calmettes, Marseille, France; INSERM U1068, Centre de Recherche en Cancérologie, Marseille, France; CNRS U7258, Université Aix-Marseille et Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France. 3. CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive, Rennes, France; Université Rennes1, Faculté de Médecine, Rennes, France; INRA UR1341 ADNC, St Gilles, France. 4. CHU Lille, Service de Chirurgie Digestive et Transplantation, Lille, France; INSERM U1172, Centre de Recherche Jean-Pierre Aubert, Lille, France. 5. CHU Lyon, Département de Chirurgie Digestive et de Transplantation Hépatique, Lyon, France. 6. Institut Paoli-Calmettes, Marseille, France. 7. CHU Nantes, Clinique de Chirurgie Digestive et Endocrinienne, Nantes, France. 8. CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive, Rennes, France; Université Rennes1, Faculté de Médecine, Rennes, France; INSERM U991, Foie Métabolismes et Cancer, Rennes, France; INSERM U1414, Centre D'investigation Clinique, Rennes, France. Electronic address: laurent.sulpice@chu-rennes.fr.
Abstract
BACKGROUND: Although the peri-operative mortality following pancreaticoduodenectomy (PD) for distal cholangiocarcinoma (DCC) has decreased, the post-operative morbidity remains high. The aim of this study was to evaluate the impact of factors that may affect the long term survival for patients with DCC following PD. METHODS: All patients who underwent PD for DCC between January 2000 and December 2015 in 5 tertiary referral centers underwent retrospective medical record review. Factors likely to influence overall (OS) and disease-free (DFS) survivals were assessed by univariate and multivariate analysis. RESULTS: A total of 201 on 217 patients who underwent PD for DCC were included for further analysis. The median OS was 39 months, with actuarial survival rates at 1, 3, and 5 years of 85%, 53% and 39%. Recurrence occurred in 123 (61%) patients. The median DFS was 16 months, with actuarial survival rates at 1, 3 and 5 years of 60%, 37% and 28%. Following multivariate analysis, peri-operative blood transfusions (PBT) were associated to worse OS (HR = 2.25 [1.31-3.85], P = 0.003) and DFS (HR = 2.08 [1.24-3.5], P = 0.005). CONCLUSION: This study confirms the negative impact of PBT on the oncologic result following PD for DCC.
BACKGROUND: Although the peri-operative mortality following pancreaticoduodenectomy (PD) for distal cholangiocarcinoma (DCC) has decreased, the post-operative morbidity remains high. The aim of this study was to evaluate the impact of factors that may affect the long term survival for patients with DCC following PD. METHODS: All patients who underwent PD for DCC between January 2000 and December 2015 in 5 tertiary referral centers underwent retrospective medical record review. Factors likely to influence overall (OS) and disease-free (DFS) survivals were assessed by univariate and multivariate analysis. RESULTS: A total of 201 on 217 patients who underwent PD for DCC were included for further analysis. The median OS was 39 months, with actuarial survival rates at 1, 3, and 5 years of 85%, 53% and 39%. Recurrence occurred in 123 (61%) patients. The median DFS was 16 months, with actuarial survival rates at 1, 3 and 5 years of 60%, 37% and 28%. Following multivariate analysis, peri-operative blood transfusions (PBT) were associated to worse OS (HR = 2.25 [1.31-3.85], P = 0.003) and DFS (HR = 2.08 [1.24-3.5], P = 0.005). CONCLUSION: This study confirms the negative impact of PBT on the oncologic result following PD for DCC.
Authors: T Peter Kingham; Victoria G Aveson; Alice C Wei; Jason A Castellanos; Peter J Allen; Daniel P Nussbaum; Yinin Hu; Michael I D'Angelica Journal: Curr Probl Surg Date: 2020-06-30 Impact factor: 1.909