OBJECTIVES: The objective of this study was to create a composite measure, optimal oncologic surgery (OOS), for patients undergoing distal pancreatectomy for pancreatic adenocarcinoma and identify factors associated with OOS. METHODS: Adult patients undergoing distal pancreatectomy were identified from the National Cancer Database between 2010 and 2016. Patients were stratified based on receipt of OOS. Criteria for OOS included 90-day survival, no 30-day readmission, length of stay ≤7 days, negative resection margins, ≥12 lymph nodes harvested, and receipt of chemotherapy. Multivariate logistic regression was performed to identify predictors of OOS. Survival curves and a Cox proportional hazards model were created to compare survival and identify risk factors for mortality. RESULTS: Three thousand five hundred forty-six patients were identified. The rate of OOS was 22.3%. Diagnosis after 2012, treatment at an academic medical center, and a minimally invasive surgical approach (MIS) were associated with OOS. Survival was superior for patients undergoing OOS. Decreasing age at diagnosis, fewer comorbidities, surgery at an academic medical center, MIS, and lower pathologic stage were also associated with improved survival on multivariate analysis. CONCLUSIONS: Rates of OOS for distal pancreatectomy are low. Time trends show increasing rates of OOS that may be related to increasing MIS, adjuvant chemotherapy, and referrals to academic medical centers.
OBJECTIVES: The objective of this study was to create a composite measure, optimal oncologic surgery (OOS), for patients undergoing distal pancreatectomy for pancreatic adenocarcinoma and identify factors associated with OOS. METHODS: Adult patients undergoing distal pancreatectomy were identified from the National Cancer Database between 2010 and 2016. Patients were stratified based on receipt of OOS. Criteria for OOS included 90-day survival, no 30-day readmission, length of stay ≤7 days, negative resection margins, ≥12 lymph nodes harvested, and receipt of chemotherapy. Multivariate logistic regression was performed to identify predictors of OOS. Survival curves and a Cox proportional hazards model were created to compare survival and identify risk factors for mortality. RESULTS: Three thousand five hundred forty-six patients were identified. The rate of OOS was 22.3%. Diagnosis after 2012, treatment at an academic medical center, and a minimally invasive surgical approach (MIS) were associated with OOS. Survival was superior for patients undergoing OOS. Decreasing age at diagnosis, fewer comorbidities, surgery at an academic medical center, MIS, and lower pathologic stage were also associated with improved survival on multivariate analysis. CONCLUSIONS: Rates of OOS for distal pancreatectomy are low. Time trends show increasing rates of OOS that may be related to increasing MIS, adjuvant chemotherapy, and referrals to academic medical centers.
Authors: Eugene P Ceppa; Henry A Pitt; Attila Nakeeb; C Max Schmidt; Nicholas J Zyromski; Michael G House; E Molly Kilbane; Alisha N George-Minkner; Beth Brand; Keith D Lillemoe Journal: J Am Coll Surg Date: 2015-05-27 Impact factor: 6.113
Authors: Hop S Tran Cao; Nicole Lopez; David C Chang; Andrew M Lowy; Michael Bouvet; Joel M Baumgartner; Mark A Talamini; Jason K Sicklick Journal: JAMA Surg Date: 2014-03 Impact factor: 14.766
Authors: Marshall S Baker; Karen L Sherman; Susan J Stocker; Amanda V Hayman; David J Bentrem; Richard A Prinz; Mark S Talamonti Journal: J Surg Oncol Date: 2014-05-26 Impact factor: 3.454
Authors: Margaret A Tempero; Mokenge P Malafa; Mahmoud Al-Hawary; Horacio Asbun; Andrew Bain; Stephen W Behrman; Al B Benson; Ellen Binder; Dana B Cardin; Charles Cha; E Gabriela Chiorean; Vincent Chung; Brian Czito; Mary Dillhoff; Efrat Dotan; Cristina R Ferrone; Jeffrey Hardacre; William G Hawkins; Joseph Herman; Andrew H Ko; Srinadh Komanduri; Albert Koong; Noelle LoConte; Andrew M Lowy; Cassadie Moravek; Eric K Nakakura; Eileen M O'Reilly; Jorge Obando; Sushanth Reddy; Courtney Scaife; Sarah Thayer; Colin D Weekes; Robert A Wolff; Brian M Wolpin; Jennifer Burns; Susan Darlow Journal: J Natl Compr Canc Netw Date: 2017-08 Impact factor: 11.908
Authors: J P Neoptolemos; D D Stocken; J A Dunn; J Almond; H G Beger; P Pederzoli; C Bassi; C Dervenis; L Fernandez-Cruz; F Lacaine; J Buckels; M Deakin; F A Adab; R Sutton; C Imrie; I Ihse; T Tihanyi; A Olah; S Pedrazzoli; D Spooner; D J Kerr; H Friess; M W Büchler Journal: Ann Surg Date: 2001-12 Impact factor: 12.969
Authors: Joal D Beane; Jeffrey D Borrebach; Amer H Zureikat; E Molly Kilbane; Vanessa M Thompson; Henry A Pitt Journal: Ann Surg Date: 2019-10-28 Impact factor: 12.969