1423 Pancreaticoduodenectomies for Pancreatic Cancer: A Single-Institution Experience

Winter, Jordan M.; Cameron, John L.; Campbell, Kurtis A.; Arnold, Meghan A.; Chang, David C.; Coleman, Jo Ann; Hodgin, Mary; Sauter, Patricia K.; Hruban, Ralph H.; Riall, Taylor S.; Schulick, Richard D.; Choti, Michael A.; Lillemoe, Keith D.; Yeo, Charles J.

doi:10.1016/j.gassur.2006.08.018

Cited by 1,354 publications

(997 citation statements)

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“…However, morbidity was still high at 41.56%, and it was not excellent compared with that reported in other institutional or national reports 2, 3, 4, 13. A PF remained the leading cause of total complications; in particular, a PF with an ISGPF grade C was associated with 76.47% of all C–D grades IV–V complications and it significantly resulted in the occurrence of a serious morbidity.…”

Section: Discussionmentioning

confidence: 65%

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Aoki

Matsubara

Konno

et al. 2017

J Hepatobiliary Pancreat Sci

128

138

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BackgroundThe morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien–Dindo classification grades IV–V), and create complication risk calculators using the Japanese National Clinical Database.MethodsBetween 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed.ResultsThe overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty‐one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non‐pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C‐indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively.ConclusionsPreventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.

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Section: Discussionmentioning

confidence: 65%

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Aoki

Matsubara

Konno

et al. 2017

J Hepatobiliary Pancreat Sci

128

138

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“…These standardized questions included their current medical condition, adherence with the walking program, the amount and type of exercise performed, their current FVAS and PVAS rating, chemotherapy or radiation therapy being received, and the presence or absence of the following 10 symptoms: fatigue, pain, shortness of breath, weight loss, anorexia, diarrhea, constipation, weakness, insomnia, and depression. This 10 symptom profile survey was based on a literature review of the most commonly reported symptoms in patients with PPC (6,11,(12)(13)(14)(15)(24)(25)(26)(27), and was administered to the IG during monthly follow-up phone calls and upon final follow-up. The UCG received the followup 10 symptom profile survey only upon final follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…For example, when 600 postings from pancreas cancer patients and their families in a monitored Internet pancreas cancer Frequently Asked Questions chat room were analyzedpain, fatigue, and anorexia were the most frequently reported symptoms by post-operative patients as well as those who did not have surgery (11). Other investigations have reported fatigue, pain, weight loss, nausea, anorexia, constipation, diarrhea, insomnia, depression, and anxiety as the most prevalent symptoms reported by PPC patients at all stages of disease (6,(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have examined the occurrence of symptoms in patients following resection of the pancreas and have found that the most common issues are: foul bowel movements, thirst, frequent urination, poor blood glucose control, heartburn, nausea and vomiting, weight loss, abdominal pain, fatigue, and muscle weakness (6,15,(25)(26)(27). This study was conceptualized using the Levine Conservation of Energy Theory as the theoretical background (28).…”

Section: Introductionmentioning

confidence: 99%

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A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients

Yeo

Burrell

Sauter

et al. 2012

Journal of the American College of Surgeons

109

148

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A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. Recommended Citation Yeo, Theresa; Burrell, Sherry A; Sauter, Patricia K; Kennedy, Eugene P; Lavu, Harish; Leiby, Benjamin E; and Yeo, Charles, "A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients." (2012 Methods:One hundred and two patients with resected PPC consented to participate in this study and were randomized to either an Intervention Group (IG) or a Usual Care Group (UCG).Subjects completed visual analog scales, the FACIT-Fatigue Scale (FFS) and the Short Form36v2® after surgery and again 3 to 6 months after hospital discharge. Results:Patients in the IG and UCG were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, pre-op fatigue and pain levels, adjuvant therapy and baseline walking distance. Patients in the IG had significantly improved scores on the FFS at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared to the UCG. Using hierarchical cluster analysis three mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG. Conclusion:This is the first prospective, randomized and controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients

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“…Most of these studies have examined the role of adjuvant treatment which has been shown to improve survival of these patients [9][10][11]. Additionally, there are reports that suggest that progress in surgical technique and perioperative care, in conjunction with the emergence of high-volume centers of excellence, has reduced the early mortality and morbidity rates after pancreatic resection [12][13][14]. The long-term survival figures however have only shown modest improvements at best.…”

Section: Introductionmentioning

confidence: 99%

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Singh

Chaudhary

2015

Indian J Surg

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Pancreatic adenocarcinoma still ranks high among cancer-related deaths worldwide. In spite of substantial strides in preoperative staging, surgery, perioperative care, and adjuvant treatment, the survival still remains dismal. A number of patient-, disease-, and surgeon-related factors play a role in deciding the eventual outcome of the patient. The aim of this commentary is to review the current knowledge of various factors and the recent advances that impact the survival of patients with pancreatic adenocarcinoma. A search of scientific literature using Embase and MEDLINE, for the years 1985-2015, was carried out for search terms Bpancreatic cancer^and Bsurvival.^Further search was based on the various specific prognostic factors that contribute towards survival of patients with pancreatic cancer found in the literature. Most of the studies used for this review include those that deal with pancreatic head cancers, some include patients with pancreatic cancers in all locations while very few included patients with tumors of body and tail only. In spite of significant developments in pre-and perioperative management, increased rates of margin-negative resections, and use of adjuvant treatment, the survival rates of pancreatic cancer patients remains poor. A paradigm shift with more effective adjuvant regimen and genetic interventions may help change the outcomes of patients with pancreatic cancer.

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1423 Pancreaticoduodenectomies for Pancreatic Cancer: A Single-Institution Experience

Cited by 1,354 publications

References 46 publications

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients

Improving Survival of Pancreatic Cancer. What Have We Learnt?

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