Has survival improved following resection for pancreatic adenocarcinoma?

Luberice, Kenneth; Downs, Darrell; Sadowitz, Benjamin; Ross, Sharona; Rosemurgy, Alexander S.

doi:10.1016/j.amjsurg.2017.05.007

Cited by 35 publications

(27 citation statements)

References 16 publications

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“…Our study demonstrates that pancreatic resections in these patients can be performed with acceptable post‐operative and survival outcomes. The survival rates in this study remain either comparable to or surpass the survival rates of patients with intraductal papillary mucinous neoplasm and concurrent extra‐pancreatic tumours or patients with PDAC alone . The improved survival figures in the present cohort are likely influenced by the fact that some of these patients had pancreatic tumours with more favourable prognostic outcomes such as solid pseudopapillary neoplasms and ampullary carcinomas …”

Section: Discussionsupporting

confidence: 49%

“…In this study, we summarize the experience of a tertiary institution in the management of patients diagnosed with a resectable pancreatic tumour and a concurrent primary extra‐pancreatic malignancy. Ten patients underwent pancreatic resections under these circumstances, with minimal morbidity, no 90‐day mortality and long‐term survival rates comparable to, or more favourable than, patients diagnosed with a pancreatic malignancy without the presence of a synchronous extra‐pancreatic tumour . Eight patients remained alive, with a median follow‐up period of 41.3 months.…”

Section: Discussionmentioning

confidence: 95%

“…Ten patients underwent pancreatic resections under these circumstances, with minimal morbidity, no 90-day mortality and long-term survival rates comparable to, or more favourable than, patients diagnosed with a pancreatic malignancy without the presence of a synchronous extra-pancreatic tumour. 19,20 Eight patients remained alive, with a median follow-up period of 41.3 months. Of these patients, six underwent pancreatic resections for a PDAC.…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Mehta

Tan

Nahm

et al. 2020

ANZ Journal of Surgery

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Background Patients may present with a resectable pancreatic tumour in the context of a concurrent primary extra‐pancreatic malignancy. These patients pose a dilemma regarding their suitability for surgery. We evaluated our experience with such patients who underwent pancreatic resection with curative intent and detailed their outcomes and rationale for surgical decision‐making. Methods A retrospective review of patients with pancreatic concurrent extra‐pancreatic primary malignancy who underwent pancreatic resection at our institution over a 12‐year period (2005–2016) was performed. Clinical, histopathological and perioperative outcomes were reviewed. Results Ten patients with a median age of 74 years (40–85 years) were identified. Secondary primary tumours included thyroid (n = 2), gastrointestinal (n = 4), small bowel neuroendocrine (n = 1), renal (n = 1) and haematological malignancies (n = 2). Pancreatic tumours included pancreatic ductal adenocarcinomas (n = 6), solid pseudopapillary neoplasms (n = 2) and ampullary carcinomas (n = 2). After a median follow up of 41.3 months (31.3–164 months), 8 of 10 patients were still alive. Two patients died due to metastatic disease from the secondary malignancy (small bowel neuroendocrine tumour and sigmoid colon adenocarcinoma). The post‐operative complication rate was 30% with no perioperative 90‐day mortality. Conclusion Selected patients with a pancreatic and concurrent primary extra‐pancreatic malignancy may undergo curative pancreatic resection with favourable outcomes.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Mehta

Tan

Nahm

et al. 2020

ANZ Journal of Surgery

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“…However, a more recent study from the United States has shown that the median survival time after resection for PDAC has significantly increased from 14 months in the years 1992 -1997 to 18 months in the years 2004 -2010 (9). Interestingly, in this study of Luberice and co-workers it was observed that the number of patients resected for PDAC who survived more than 5 years did not changed over the years (9). Nevertheless, the prognosis of a patient resected for PDAC is mainly determined by tumor-related factors such as tumor diameter, lymph nodes involvement, differentiation grade, resection margins status and completion of adjuvant therapy (10).…”

Section: Resectable Pdacmentioning

confidence: 99%

“…However, it appears that the use of modern chemotherapy schemes was associated with improved survivals (9). Thus, the use of FOLFIRINOX or FOLFOX in M1 PDAC has significantly increased the survivals in M1 PDAC, compared with gemcitabine alone, leading to a median survival time of around 11 months (81,82).…”

Section: Resection For M1 Pdacmentioning

confidence: 99%

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

Popescu¹,

Dumitraşcu²

2017

SGO

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Pancreatic ductal adenocarcinoma (PDAC) is an important healthcare problem because is a leading cause of death by cancer. PDAC is a highly lethal disease with a very dismal prognosis. Most patients present advanced disease at diagnosis. The management of a patient diagnosed with PDAC should be discussed in a multidisciplinary team in high-volume centers. Pancreatectomy represents the single hope of long-term survival for a patient with PDAC but the resectability rate is less than 20% of the cases. Several progresses were observed in the last years regarding the surgical and oncological approach for PDAC. The aim of the paper is to make a brief review of the current onco-surgical strategies available for patients with PDAC.

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Development and validation of novel nomograms for predicting the survival of patients after surgical resection of pancreatic ductal adenocarcinoma

Chen

et al. 2020

Cancer Medicine

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Background/AimsPancreatic ductal adenocarcinoma (PDAC) is associated with high mortality, even after surgical resection. The existing predictive models for survival have limitations. This study aimed to develop better nomograms for predicting overall survival (OS) and cancer‐specific survival (CSS) in PDAC patients after surgery.MethodsA total of 6323 PDAC patients were retrospectively recruited from the Surveillance, Epidemiology, and End Results (SEER) database and randomly allocated into training, validation, and test cohorts. Multivariate Cox regression analysis was conducted to identify significant independent factors for OS and CSS, which were used for construction of nomograms. The performance was evaluated, validated, and compared with that of the 8th edition AJCC staging system.ResultsTen independent factors were significantly correlated with OS and CSS. The 1‐, 3‐, and 5‐year OS rates were 40%, 20%, and 15%, and 1‐, 3‐, and 5‐year CSS rates were 45%, 24%, and 19%, respectively. The nomograms were calibrated well, with c‐indexes of 0.640 for OS and 0.643 for CSS, respectively. Notably, relative to the 8th edition AJCC staging system, the nomograms were able to stratify each AJCC stage into three prognostic subgroups for more robust risk stratification. Furthermore, the nomograms achieved significant clinical validity, exhibiting wide threshold probabilities and high net benefit. Performance assessment also showed high predictive accuracy and reliability.ConclusionsThe predictive ability and reliability of the established nomograms have been validated, and therefore, these nomograms hold potential as novel approaches to predicting survival and assessing survival risks for PDAC patients after surgery.

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Has survival improved following resection for pancreatic adenocarcinoma?

Cited by 35 publications

References 16 publications

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Onco-surgical Strategies in Pancreatic Ductal Adenocarcinoma

Development and validation of novel nomograms for predicting the survival of patients after surgical resection of pancreatic ductal adenocarcinoma

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