Surgical management in patients with pancreatic cancer: a Queensland perspective. Issue 11 (24th October 2012)

• Record Type: Journal Article
• Authors: Wylie, Neil; Adib, Reza; Barbour, Andrew P.; Fawcett, Jonathan; Hill, Alexander; Lynch, Stephen; Martin, Ian; O'Rourke, Thomas R.; Puhalla, Harald; Rutherford, Leigh; Slater, Kellee; Whiteman, David C.; Neale, Rachel E.
• Is Part Of: ANZ journal of surgery. Volume 83:Issue 11(2013)
• Page Start: 859
• Page End: 864
• Publication Date: 2012-10-24
• Subjects: Australia -- general surgery -- neoplasms -- pancreatic neoplasms -- therapeutics; Surgery -- Periodicals; 617.005
• DOI: 10.1111/j.1445-2197.2012.06312.x
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: Little has been published regarding presenting symptoms, investigations and outcomes for patients with pancreatic cancer in Australia. Data from a series of patients undergoing attempted resection in Queensland, Australia, are presented with the aim of assisting development of consistent strategies in disease management. Methods: We reviewed the medical records of 121 patients who underwent attempted surgical resection and who took part in a case‐control study between 2007 and 2009. Information relating to symptoms, investigations, surgical procedures and outcomes was captured. Results: The mean age was 63 years and 60% were men. The most common presenting symptoms were jaundice (64%) and pain (63%). Over 80% of patients had multiple imaging investigations or laparoscopy prior to surgery. Seventy‐eight patients (64%) had a completed resection and 23% of these had involved margins. The presence of metastases and/or involvement of vessels or adjacent structures precluded resection in the remaining patients. The 1‐year survival for patients whose resections were completed was 77% compared with 51% for those whose tumours were not resectable ( P = 0.004). There was no 30‐day mortality and 68% of patients were alive 1 year after diagnosis. Resections were performed in 11 different hospitals but over 90% of patients underwent their surgery in one of five high‐volume centres. Conclusion: The Queensland experience is consistent with that reported internationally. A significant proportion of attempted resections was not completed because preoperative staging underestimated disease extent. Most patients with potentially resectable disease are being treated in high‐volume centres.