Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Issue 2 (18th December 2015)

• Record Type: Journal Article
• Authors: Pugalenthi, Amudhan; Protic, Mladjan; Gonen, Mithat; Kingham, T. Peter; Angelica, Michael I.D'.; Dematteo, Ronald P.; Fong, Yuman; Jarnagin, William R.; Allen, Peter J.
• Is Part Of: Journal of surgical oncology. Volume 113:Issue 2(2016)
• Page Start: 188
• Page End: 193
• Publication Date: 2015-12-18
• Subjects: pancreaticoduodenectomy -- pancreatic ductal adenocarcinoma -- survival -- complications; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24125
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : 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: A total of 596 patients that underwent PD for PDA between 2001 and 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. J. Surg. Oncol. 2016;113:188–193 . © 2015 Wiley Periodicals, Inc.