Recurrence Pattern and Prognosis of Pancreatic Cancer After Pancreatic Fistula

Nagai, Shunji; Fujii, Tsutomu; Kodera, Yasuhiro; Kanda, Mitsuro; Sahin, Tevfik Tolga; Kanzaki, Akiyuki; Hayashi, Masamichi; Sugimoto, Hiroyuki; Nomoto, Shuji; Takeda, Shin; Morita, Satoshi; Nakao, Akimasa

doi:10.1245/s10434-011-1604-8

Cited by 58 publications

(55 citation statements)

References 29 publications

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“…Similar results have been demonstrated by other investigators . In an analysis of data from 184 PDAC patients who received potentially curative pancreatectomy, Nagai et al reported that pancreatic fistula was an independent prognostic factor . Moreover, a significant adverse correlation was found between postoperative morbidity and the initiation of adjuvant therapy.…”

Section: Discussionsupporting

confidence: 82%

Prognostic impact of postoperative complication after pancreatoduodenectomy for pancreatic adenocarcinoma stratified by the resectability status

Kondo

Murakami

Uemura

et al. 2018

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 82%

Prognostic impact of postoperative complication after pancreatoduodenectomy for pancreatic adenocarcinoma stratified by the resectability status

Kondo

Murakami

Uemura

et al. 2018

Journal of Surgical Oncology

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“…Similarly, Assifi et al reported that tumor recurrence after PD for PDA was independent of development of postoperative pancreatic fistula [35]. On the other hand, Nagai et al reported that pancreatic fistula was a negative predictor for tumor recurrence [36]. It has been reported that an inverse relationship exists between postoperative morbidity and the initiation of adjuvant therapy.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

Pugalenthi

Protić

Gönen

et al. 2015

Journal of Surgical Oncology

125

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INTRODUCTION Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40–50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. METHODS 596 patients that underwent PD for PDA between 2001–2009 were identified from a prospective database. Complications were defined and graded (1–5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥ grade 3. Postoperative mortality (≤ 90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. RESULTS Median survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n= 129). Our 90 day mortality was 3.7% (n= 22). Anastomotic fistula/ leak/abscess rate was 14% (n= 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) > 600 ml, length of stay (LOS) > 10 days, margin positivity and vascular procedures as predictors of decreased overall survival (p < 0.05). High grade complications were not associated with overall survival (p = 0.948). CONCLUSION In this study, the occurrence of high grade postoperative complications was not associated with overall survival.

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“…Common postoperative complications are wound infections, delayed gastric emptying (DGE) and pancreatic fistula (POPF). POPF occur in 9–40% in large studies [5], [6], [7], [8], [9], impact patient comfort, and lead to prolonged hospital stay as well as higher re-admission and re-intervention rates [5], [6], [7], POPF may even cause fatal complications such as sepsis induced by intra-abdominal abscesses or hemorrhage evoked by ruptured intra-abdominal aneurysms [10], and increases the risk of cancer recurrence [11]. Therefore, causal factors of postoperative complications after PD must be better identified and targeted.…”

Section: Introductionmentioning

confidence: 99%

Complications after pancreaticoduodenectomy are associated with higher amounts of intra- and postoperative fluid therapy: A single center retrospective cohort study

Kulemann

Fritz

Glatz

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundPerioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity.Materials and methodsWe retrospectively examined data of 553 patients who underwent pancreaticoduodenectomy at University of Freiburg Medical Center between 2001 and 2013. Data on intra - and postoperative fluid administration (until postoperative day 5) were obtained from anesthesiological and surgical records. Data on complications were retrieved from our institutional pancreatic database.ResultsThe median values for intra- and total fluid administered were 6000 ml (range 400–15,000 ml) and 13,600 ml (range 5000–57,700 ml), respectively. The overall in-hospital mortality was 1.9% (no correlation with fluid administration). Patients who received more than 6000 ml intraoperative fluid had more wound infections (P = 0.049), intra-abdominal abscesses (P = 0.020) and postoperative interventions (P = 0.007). In patients who received more than 14000 ml fluid until postoperative day 5 all evaluated types of postoperative complications (infectious, fistula, delayed gastric emptying, bleeding) and re-interventions occurred significantly more frequently than in patients who received less than 14,000 ml (P < 0.05–0.001).ConclusionsHigher amounts of fluids may contribute to postoperative complications. More studies are needed to adequately assess the use of intra/postop fluid therapy.

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Recurrence Pattern and Prognosis of Pancreatic Cancer After Pancreatic Fistula

Abstract: PF was statistically significantly related to peritoneal recurrence, and patients with PF developed peritoneal recurrence earlier than those without PF. With regard to the development of peritoneal recurrence, PF may be considered to be a negative prognostic factor.

Cited by 58 publications

References 29 publications

Prognostic impact of postoperative complication after pancreatoduodenectomy for pancreatic adenocarcinoma stratified by the resectability status

Prognostic impact of postoperative complication after pancreatoduodenectomy for pancreatic adenocarcinoma stratified by the resectability status

Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

Complications after pancreaticoduodenectomy are associated with higher amounts of intra- and postoperative fluid therapy: A single center retrospective cohort study

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