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Detrimental effect of postoperative complications on oncologic efficacy of R0 pancreatectomy in ductal adenocarcinoma of the pancreas

 Chang Moo Kang  ;  Dong Hyun Kim  ;  Gi Hong Choi  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Woo Jung Lee 
 Journal of Gastrointestinal Surgery, Vol.13(5) : 907-914, 2009 
Journal Title
 Journal of Gastrointestinal Surgery 
Issue Date
Adult ; Aged ; Carcinoma, Pancreatic Ductal/mortality* ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Pancreatic Ductal/surgery* ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm, Residual ; Pancreatectomy/adverse effects* ; Pancreatic Neoplasms/mortality* ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy/adverse effects* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome
Pancreatic cancer ; Complication ; R0 ; Pancreatectomy ; Survival
BACKGROUND: Margin-negative resection of pancreatic cancers has proven to be the most effective treatment to date. Although there are frequent surgery-related complications following pancreatectomy, the oncologic effect of these complications following pancreatectomy for pancreatic cancer has not been studied. MATERIALS AND METHODS: Retrospective observation of medical records of resected pancreatic ductal adenocarcinoma performed from January 1990 to June 2006 was used in this study. Potentially curative surgical resections of pancreatic ductal adenocarcinoma were performed on 103 patients. Survival was analyzed according to various clinicopathologic variables. RESULTS: Negative surgical margins (p = 0.0075) and absence of postoperative major complications related to surgery (p = 0.0116) were all significantly favorable prognostic factors in both univariate and multivariate analysis. Margin-negative pancreatectomy without major complications showed the most favorable oncologic outcomes in resected pancreatic cancer (median survival, 35.6 months; 95% confidential interval, 25.8-45.4 months), while major morbidities diminished survival benefit of R0 resection [R0-Cx(+), Exp(beta) = 1.925, p = 0.034, and R1, Exp(beta) = 3.129, p = 0.001]. CONCLUSION: Surgery-related major complication diminished the oncologic efficacy of R0 pancreatectomy. Margin-negative resection without major complication can enhance postoperative oncologic outcomes in ductal adenocarcinoma of the pancreas
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Dong Hyun(김동현)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
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