Long-term survival after pancreaticoduodenectomy in patients with ductal adenocarcinoma of the pancreatic head

Luu, Andreas Minh; Braumann, Chris; Belyaev, Orlin; Janot‐Matuschek, Monika; Rudolf, Henrik; Praktiknjo, Michael; Uhl, Waldemar

doi:10.1016/j.hbpd.2020.12.006

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Since pancreatic cancer is thought to have median survival of 19.5-24 months after curative resection, [27][28][29] subgroup analysis was performed comparing patients with more than a 24 month-survival period and those who had a shorter survival than 24 months.…”

Section: Study Design and Populationmentioning

confidence: 99%

Prognosis of pancreaticoduodenectomy in octogenarians for pancreatic ductal adenocarcinoma with propensity score matched analysis

Jeong,

Lim,

Jeon

et al. 2023

ANZ Journal of Surgery

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BackgroundThis retrospective study investigates factors affecting surgical and oncological outcome after performing pancreaticoduodenectomy in octogenarian patients diagnosed with pancreatic ductal adenocarcinoma.MethodsFrom January 2009 to December 2018, patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma were included. Data were analysed by comparing clinicopathological characteristics, complications, survival, recurrence, adjuvant treatment between octogenarians and the younger group. Propensity score matched analysis was performed due to the small size of the octogenarian group.ResultsA total of 666 patients were included in this study and 24 (3.6%) were included in the octogenarian group. Short term complication rates (P = 0.119) and hospital stay (P = 0.839) did not differ between two groups. Overall survival between the two groups showed significant difference (<80 median 25 months versus ≥80 median 13 months, P = 0.045). However, after propensity score matched analysis, the two groups did not differ in overall survival (<80 median 18 months versus ≥80 median survival 16 months, P = 0.565) or disease‐free survival (P = 0.471). Among the octogenarians, six patients survived longer than 24 months even without satisfying all favourable prognostic factors.ConclusionConsidering the general condition of octogenarians diagnosed with pancreatic ductal adenocarcinoma, select patients should be treated more aggressively for the best chance of receiving curative treatment.

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Section: Study Design and Populationmentioning

confidence: 99%

Prognosis of pancreaticoduodenectomy in octogenarians for pancreatic ductal adenocarcinoma with propensity score matched analysis

Jeong,

Lim,

Jeon

et al. 2023

ANZ Journal of Surgery

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“…High recurrence rate limits long-term survival after pancreatic cancer surgery and represents a major clinical challenge in the management of patients with pancreatic malignancies. [1][2][3] This emphasizes the need to identify novel modalities for management and a move to a personally tailored surgical management. [4][5][6] Scientific data on the surgical importance of the pancreatic duct anatomy and its impact on surgical and oncologic outcomes is scarce.…”

Section: Introductionmentioning

confidence: 99%

“…High recurrence rate limits long‐term survival after pancreatic cancer surgery and represents a major clinical challenge in the management of patients with pancreatic malignancies 1–3 . This emphasizes the need to identify novel modalities for management and a move to a personally tailored surgical management 4–6 .…”

Section: Introductionmentioning

confidence: 99%

Value of the surgical pancreatic duct anatomy and associated outcomes in pancreatic cancer

Harris,

Atanasov,

Neo

et al. 2024

ANZ Journal of Surgery

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IntroductionPancreatic cancer recurrence following surgery is a significant challenge, and personalized surgical care is crucial. Topographical variations in pancreatic duct anatomy are frequent but often underestimated. This study aimed to investigate the potential importance of these variations in outcomes and patient survival after Whipple's procedures.MethodsData were collected from 105 patients with confirmed pancreatic head neoplasms who underwent surgery between 2008 and 2020. Radiological measurements of pancreatic duct location were performed, and statistical analysis was carried out using IBM SPSS.ResultsInferior pancreatic duct topography was associated with an increased rate of metastatic spread and tumour recurrence. Additionally, inferior duct topography was associated with reduced overall and recurrence‐free survival. Posterior pancreatic duct topography was associated with decreased incidence of perineural sheet infiltration and improved overall survival.DiscussionThese findings suggest that topographical diversity of pancreatic duct location can impact outcomes in Whipple's procedures. Intraoperative review of pancreatic duct location could help surgeons define areas of risk or safety and deliver a personalized surgical approach for patients with beneficial or deleterious anatomical profiles. This study provides valuable information to improve surgical management by identifying high‐risk patients and delivering a personalized surgical approach with prognosis stratification.

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“…Due to its extremely aggressive nature, radical resection is the only chance for long-term survival for patients with PDAC. However, even after radical resection, most patients still have tumor recurrence or metastasis, resulting in 5-year survival of only 12% to 27%, negatively affecting the curative nature of the operation and the prognosis of PDAC patients ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram to predict liver metastasis for pancreatic ductal adenocarcinoma after radical resection

Tong

Jiang²,

Mao³

et al. 2022

Front. Oncol.

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ObjectivesThis study aimed to develop and externally validate a nomogram for predicting liver metastasis after radical resection in patients with pancreatic ductal adenocarcinoma (PDAC).MethodsA total of 247 PDAC patients who underwent radical resection were retrospectively reviewed from January 2015 to March 2022 at Ningbo Medical Centre Lihuili Hospital Eastern Section, and used as a training cohort to develop the nomogram. 83 PDAC patients from the Ningbo Medical Centre Lihuili Hospital Xingning Section were enrolled as the validation cohort. The postoperative liver metastasis was recorded during the follow-up, and the liver metastasis-free survival was defined as the time from operation to the date of liver metastasis diagnosis or death. The nomogram was established based on independent prognostic factors selected by LASSO and multivariate Cox regression model. The performance was assessed using the concordance index (C-index) and calibration curves. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to determine the clinical utility of the nomogram model.ResultsFrom the training cohort of 247 patients, a total of 132 patients developed liver metastasis during the follow-up, the 1-, 2- and 3- year liver metastasis-free survival were 52.4%, 43.5% and 40% respectively. The LASSO and multivariate Cox regression analysis indicated that postoperative CA125 (hazard ratio [HR] = 1.007, p <0.001), tumor differentiation (HR = 1.640, p = 0.010), tumor size (HR = 1.520, p = 0.029), lymph node ratio (HR = 1.897, p = 0.002) and portal/superior mesenteric/splenic vein invasion degree (PV/SMV/SV) (HR = 2.829, p <0.001) were the independent factors of liver metastasis. A nomogram with independent factors was developed and the C-index was 0.760 (95% confidence interval [CI], 0.720-0.799) and 0.739 (95% CI, 0.669-0.810) in the training and validation cohorts, respectively. The areas under curve (AUC) of the nomogram at 1-, 2- and 3-year were 0.815, 0.803 and 0.773 in the training cohort, and 0.765, 0.879 and 0.908 in the validation cohort, respectively, higher than those in TNM stage. Decision curve analysis (DCA) analysis revealed that the nomogram model provided superior net benefit in clinical utility. Liver metastasis-free survival curves showed a significant discriminatory ability for liver metastasis risk based on the nomogram (p <0.001).ConclusionsThe nomogram showed high accuracy in predicting liver metastasis for PDAC after radical resection, and may serve as a clinical support tool to guide personalized and prescient intervention.

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Long-term survival after pancreaticoduodenectomy in patients with ductal adenocarcinoma of the pancreatic head

Cited by 9 publications

References 35 publications

Prognosis of pancreaticoduodenectomy in octogenarians for pancreatic ductal adenocarcinoma with propensity score matched analysis

Prognosis of pancreaticoduodenectomy in octogenarians for pancreatic ductal adenocarcinoma with propensity score matched analysis

Value of the surgical pancreatic duct anatomy and associated outcomes in pancreatic cancer

Development and validation of a nomogram to predict liver metastasis for pancreatic ductal adenocarcinoma after radical resection

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