Predictors of long-term survival after pancreaticoduodenectomy for peri-ampullary adenocarcinoma: A retrospective study of 5-year survivors

Nakeeb, Ayman El; Sorogy, Mohamed El; Ezzat, Helmy; Said, Rami; Dosoky, Mohamed El; Gawad, Mohamed Abd El; Elsabagh, A.M.; Hanafy, Ehab El

doi:10.1016/j.hbpd.2018.08.004

Cited by 34 publications

(31 citation statements)

References 38 publications

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“…PD has become a relatively safe operation in many large volume centers. Many surgeons have developed and reported their experiences of PDs and described their outcomes [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Representatively, after comparing and studying the existing Whipple operation and the method of preserving the pylorus, it can be said that the popularization of pylorus preserving PD (PPPD) is a very important history [ 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…In terms of postoperative long-term outcomes, survival rates of patients with periampullary diseases who undergo PD have been gradually improved over time [ 8 , 9 , 11 ], although the overall survival of patients with pancreatic cancer is still very low [ 3 , 4 , 5 , 6 , 7 , 8 , 10 , 12 ]. These improvements would be the result of complex synergies of various efforts and strategies used by surgeons to improve postoperative outcomes as well as the development of diagnosis and adjuvant therapy by physicians rather than one change in a specific factor.…”

Section: Introductionmentioning

confidence: 99%

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Three Thousand Consecutive Pancreaticoduodenectomies in a Tertiary Cancer Center: A Retrospective Observational Study

Jung

Choi

Yoon

et al. 2020

JCM

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(1) Aim: To evaluate clinicopathological features and postoperative outcomes including survival in patients who underwent pancreaticoduodenectomy (PD) for periampullary diseases. (2) Methods: We retrospectively reviewed 3078 cases of PD performed in our center for 25 years. Periampullary diseases were divided into benign and malignancy groups. All cases were also classified by location. The time of 25 years was divided to different periods (5 years per period) to compare outcomes. Overall survival was compared between subdivided periods. (3) Results: Hospitalization became significantly shorter from 28.0 days in the 1st period to 13.8 days in the 5th period. Overall complication rate was significantly increased since the 3rd period. The rate without postoperative pancreatic fistula (POPF) was high at 98.7% in the 1st period. This might be because drain amylase on the 3rd day after PD was not routinely checked in the past. Thus, POPF was not detected. In survival analysis of adenocarcinoma of pancreas, bile duct, and ampulla, overall survival was found to be improved significantly in recent years. (4) Conclusions: Our study revealed that outcomes were improved with increasing number of PDs performed. Although POPF and overall complications showed increases more recently, those were detected and managed, resulting in shorter hospitalization and improved outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three Thousand Consecutive Pancreaticoduodenectomies in a Tertiary Cancer Center: A Retrospective Observational Study

Jung

Choi

Yoon

et al. 2020

JCM

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“…El Nakeeb et al, in their study, showed that 5-year survival was 20.6% in PAAC with a median survival of 34 months. The worst prognosis was reported in pancreatic head AC with 5%–20% 5-year survival, and a better prognosis was in ampullary and duodenal AC with 5-year survival 30%–65% [ 20 ]. Also, Zakaria et al, demonstrated that 5-year survival rate in patients with PDAC was 23.4% [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gao et al have suggested that periampullary cancer patients with preoperative serum CA19-9 > 35 U/ml are prone to have a poorer survival [ 28 ]. Also, El Nakeeb et al, showed that preoperative serum CA19-9 > 37 U/ml was associated with a poor survival rate [ 20 ]. In the present study the elevated CA 19-9 (>400U/ml) had a statistical significance risk for poor survival in univariate analysis, similar to the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Venous reconstruction can be done if there is an invasion of porto-mesentric access to achieve R0 resection with accepted postoperative morbidity and mortality. Some studies showed that the resection margin was an independent risk factor for survival, and R0 achieved significantly better OS [ 6 , 7 , 20 , 31 ]. In contrast, the meta-analysis study by Butturini et al, found that resection margin was not a significant prognostic factor for survival [ 32 ] as seen in our study, it may be due to the difference in the pathological definitions and findings of the resection margin.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study

Zakaria

Sallam

Ayoub

et al. 2020

Annals of Medicine and Surgery

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Background Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. Patients and methods This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. Result There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084–0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020–0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046–0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. Conclusion It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC.

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Preoperative diagnosis of perineural invasion in patients with periampullary carcinoma by MSCT imaging: preliminary observations and clinical implications

et al. 2022

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Predictors of long-term survival after pancreaticoduodenectomy for peri-ampullary adenocarcinoma: A retrospective study of 5-year survivors

Cited by 34 publications

References 38 publications

Three Thousand Consecutive Pancreaticoduodenectomies in a Tertiary Cancer Center: A Retrospective Observational Study

Three Thousand Consecutive Pancreaticoduodenectomies in a Tertiary Cancer Center: A Retrospective Observational Study

Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study

Preoperative diagnosis of perineural invasion in patients with periampullary carcinoma by MSCT imaging: preliminary observations and clinical implications

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