Perioperative Factors Associated With Survival Following Surgery for Pancreatic Cancer – a Nationwide Analyses of 473 Cases From Denmark

Abstract

Background Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal cancer diseases worldwide, with an overall 5-year survival rate of only 5%. The effects of perioperative treatment factors including operation time, blood transfusions as well as choice of anesthesia and analgesia techniques on overall survival (OS) following pancreatic resections for PDAC, is currently not well known. We hypothesized that these perioperative factors could be associated with OS following pancreatic resections for PDAC. METHODS Retrospective study from a nationwide cohort of PDAC patients from 2011 to 2020 in Denmark. Data was obtained by joining the national Danish Pancreatic Cancer Database (DPCD) and the Danish Anesthesia Database (DAD). Associations between OS as the primary endpoint, and perioperative factor were assessed using Hazard Ratios (HRs) calculated by cox regression controlled for relevant confounders. RESULTS Overall, data from 473 resected PDAC patients were available. Multivariate cox regression indicated that perioperative blood transfusions were associated with shorter OS (HR 2.53, p = 0.005), with survival estimates of 8.8% in transfused vs. 28.0% in non-transfused patients at 72 months after surgery. No significant associations could be identified for operation time or anesthesia/analgesia techniques. CONCLUSION In this study, the use of perioperative blood transfusions was associated with shorter OS.