BACKGROUND/AIMS: The aim of this retrospective multicentric study was to compare the results of resections with those of surgical palliative procedures. MATERIAL AND METHODS: The 3231 patients included had histologically proven adenocarcinoma of the pancreas and were operated on between 1982 and 1988. Seven hundred eighty-seven underwent surgical resection, and 2444 a palliative procedure. Step by step logistic regression was used to determine variables having the greatest impact on post operative mortality. Survivals were compared with the logRank test. A semi parametric Cox model was applied to estimate adjusted relative risk of death. RESULTS: After resection and bypass, postoperative mortality was 10% and 15% (P < 0.001), morbidity 35% and 27% (P < 0.001), and mean survival times 19.5 months (SE = 1.1), and 8.8 months (SE = 0.3) (P < 0.001) respectively. In patients without metastases, survival was better after resection than after bypass, even in patients with involvement of lymph nodes adjacent to or distant from the tumor (P = 0.001). CONCLUSIONS: In spite of the retrospective nature of such comparisons, these results acredit the idea that in patients with pancreatic cancer without metastases, resection should be attempted whenever possible.
BACKGROUND/AIMS: The aim of this retrospective multicentric study was to compare the results of resections with those of surgical palliative procedures. MATERIAL AND METHODS: The 3231 patients included had histologically proven adenocarcinoma of the pancreas and were operated on between 1982 and 1988. Seven hundred eighty-seven underwent surgical resection, and 2444 a palliative procedure. Step by step logistic regression was used to determine variables having the greatest impact on post operative mortality. Survivals were compared with the logRank test. A semi parametric Cox model was applied to estimate adjusted relative risk of death. RESULTS: After resection and bypass, postoperative mortality was 10% and 15% (P < 0.001), morbidity 35% and 27% (P < 0.001), and mean survival times 19.5 months (SE = 1.1), and 8.8 months (SE = 0.3) (P < 0.001) respectively. In patients without metastases, survival was better after resection than after bypass, even in patients with involvement of lymph nodes adjacent to or distant from the tumor (P = 0.001). CONCLUSIONS: In spite of the retrospective nature of such comparisons, these results acredit the idea that in patients with pancreatic cancer without metastases, resection should be attempted whenever possible.
Authors: Jörg Köninger; Moritz N Wente; Michael W Müller; Carsten N Gutt; Helmut Friess; Markus W Büchler Journal: Langenbecks Arch Surg Date: 2006-11-11 Impact factor: 3.445
Authors: Jörg Köninger; Moritz N Wente; Beat P Müller-Stich; Francesco F di Mola; Carsten N Gutt; Ulf Hinz; Michael W Müller; Helmut Friess; Markus W Büchler Journal: Langenbecks Arch Surg Date: 2008-02-29 Impact factor: 3.445