Clinical and Pathologic Features Influencing Survival in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma Journal Article

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Authors: Weber, C. E.; Bock, E. A.; Hurtuk, M. G.; Abood, G. J.; Pickleman, J.; Shoup, M.; Aranha, G. V.
Article Title: Clinical and Pathologic Features Influencing Survival in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma
Abstract: OBJECTIVE: The aim of the study was to determine the clinicopathological features that influence survival in patients with resected pancreatic ductal adenocarcinoma (PDA). METHODS: The study used a single institution retrospective review of patients undergoing pancreaticoduodenectomy (PD) for PDA from 1993 to 2010. RESULTS: Two hundred forty-six consecutive cases of resected PDA were identified: 128 males (52 %), median age 68 years. Median hospital length of stay was 8 days and 30-day mortality rate was 2.4 %. There were 101 (41.1 %) postoperative complications, 77 % of which were Dindo-Clavien Grade 3 or less. Overall survival was 85, 63, 25, and 15 % at 6 months, 1 year, 3 years, and 5 years, respectively, with a median survival of 17 months. Multivariate Cox proportional hazard modeling demonstrated lymph node ratio was negatively correlated with survival at all time points. Preoperative hypertension was a poor prognostic factor at 6 months, 3 years, and 5 years. The absence of postoperative complications was protective at 6 months whereas pancreatic leaks were associated with worse survival at 6 months. Abdominal pain on presentation, operative time, and estimated blood loss were also associated with decreased survival at various time points. CONCLUSION: The strongest prognostic variable for short- and long-term survival after PD for PDA is lymph node ratio. Short-term survival is influenced by the postoperative course.
Journal Title: Journal of Gastrointestinal Surgery
ISSN: 1873-4626
Publisher: Unknown  
Date Published: 2013
Language: ENG
DOI/URL:

10.1007/s11605-013-2388-x
Notes: JID: 9706084; 2013/05/14 [received]; 2013/10/07 [accepted]; 2013/11/23 [aheadofprint]; aheadofprint