Can Statistically Determined Prognostic Factors Predict the Long-Term Survival of Patients With Pancreatic Ductal Adenocarcinoma Following Surgical Resection?

Pancreas ◽  
2014 ◽  
Vol 43 (4) ◽  
pp. 571-577 ◽  
Author(s):  
Sang Hyun Shin ◽  
Song Cheol Kim ◽  
Seung-Mo Hong ◽  
Ki-Byung Song ◽  
Jae Hoon Lee ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Resection ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Long Term Survival

Prognostic factors for actual long-term survival in the era of multidisciplinary treatment for pancreatic ductal adenocarcinoma

2018 ◽  
Vol 403 (6) ◽  
pp. 693-700 ◽  
Author(s):  
Kenji Nakagawa ◽  
Takahiro Akahori ◽  
Satoshi Nishiwada ◽  
Minako Nagai ◽  
Kota Nakamura ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Multidisciplinary Treatment ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Vascular resection for locally advanced pancreatic ductal adenocarcinoma: analysis of long-term outcomes from a single-centre series

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Claudio F. Feo ◽  
Giulia Deiana ◽  
Chiara Ninniri ◽  
Giuseppe Cherchi ◽  
Paola Crivelli ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Locally Advanced ◽  
Operating Time ◽  
Vascular Resection ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Aggressive Approach ◽  
Long Term Survival ◽  
Cox Regression Analysis

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis. Radical surgery is the best option for cure and, nowadays, it is performed by many surgeons also in cases of vascular infiltration. Whether this aggressive approach to a locally advanced PDAC produces a survival benefit is under debate. Most data in the literature come from retrospective comparative studies; therefore, it is still unclear if such an extensive surgery for an advanced cancer is justified. Methods A retrospective review of patients with PDAC treated at our institution over a 12-year period was performed. Data concerning patients’ characteristics, operative details, postoperative course, and long-term survival were retrieved from prospective databases and analysed. Factors associated with poor survival were assessed via Cox regression analysis. Results A total of 173 patients with PDAC were included in the analysis, 41 subjects underwent pancreatectomy with vascular resection for locally advanced disease, and in 132 patients, only a pancreatic resection was undertaken. Demographics, major comorbidities, and tumour characteristics were similar between the two groups. Length of surgery (P=0.0006), intraoperative blood transfusions (P<0.0001), and overall complications (P<0.0001) were significantly higher in the vascular resection group. Length of hospital stay (P=0.684) and 90-day mortality (P=0.575) were comparable between groups. Overall median survival (P= 0.717) and survival rates at 1, 3, and 5 years (P=0.964, P=0.500, and P=0.445, respectively) did not differ significantly between groups. Age ≥70 years and postoperative complications were independent predictors of lower survival. Conclusions Our study confirms that pancreatectomy with vascular resection for a locally advanced PDAC is a complex operation associated with a significant longer operating time that may increase morbidity; however, in selected patients, R0 margins can be obtained with an acceptable long-term survival rate. Older patients are less likely to benefit from surgery.

scholarly journals Survival and quality of life following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Short Review ◽  
Mortality Rates ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Long Term Survival ◽  
Dismal Prognosis

Pancreatic ductal adenocarcinoma (PDAC) most commonly affects the head of the pancreas. This condition has a dismal prognosis. Patients with early disease may be candidates for pancreaticoduodenectomy (PD). This is a high-risk operation which is associated with considerable morbidity. Whilst perioperative mortality rates have fallen in recent times, the risk remains significant and long-term survival is poor, even in those who make an uncomplicated recovery. Furthermore, PD is known to affect quality of life (QoL) negatively. Most studies suggest it takes up to six months before a patient’s QoL returns to baseline. This is a considerable amount of time for a patient who is unlikely to achieve long-term survival. This short review discusses the recent literature surrounding mortality rates, long-term survival and QoL following PD for PDAC. A comprehensive understanding of these topics will allow clinicians and patients to consider the risks and benefits before surgical resection is considered.

Su1825 Detailed Analysis of EMT and Tumor Budding Identifies Predictors of Long Term Survival in Pancreatic Ductal Adenocarcinoma

2014 ◽  
Vol 146 (5) ◽  
pp. S-1046
Author(s):  
Peter Bronsert ◽  
Ilona Kohler ◽  
Dirk Bausch ◽  
Tobias Keck ◽  
Martin Werner ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Detailed Analysis ◽  
Tumor Budding ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Additive Value of Preoperative Sarcopenia and Lymphopenia for Prognosis Prediction in Localized Pancreatic Ductal Adenocarcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Christelle d’Engremont ◽  
Julienne Grillot ◽  
Julie Raillat ◽  
Dewi Vernerey ◽  
Lucine Vuitton ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Resection ◽  
Lymphocyte Count ◽  
Prognostic Score ◽  
Preoperative Evaluation ◽  
High Risk Group ◽  
University Hospital ◽  
Ductal Adenocarcinoma ◽  
Term Survival

BackgroundSurgical resection with adjuvant chemotherapy is the only treatment that can provide long term survival in localized pancreatic ductal adenocarcinoma (LPDAC). Notwithstanding, recurrence occurs in the vast majority of patients and a better stratification of preoperative therapies is required. This study aimed to investigate preoperative immunological and nutritional factors to predict relapse-free survival (RFS) in patients with LPDAC.MethodsAnalyses were derived from all consecutive LPDAC patients treated with surgical resection at Besancon University Hospital, France, between January 2006 and December 2014 (n=146). Biological and nutritional parameters were recorded before and after surgery. The association of 24 baseline parameters with RFS was evaluated using univariate and multivariate Cox analyses. Based on the final model, a prognostic score was developed.ResultsLymphocyte count and body composition were available for 94 patients. In multivariate analysis, preoperative lymphopenia and sarcopenia (or a low muscle mass) were identified as independent prognostic factors for RFS. The score determined three groups with a median RFS of 5.6 months (95% confidence interval [CI] = 4.3 to 9.6 months) for high-risk group, corresponding to patients with lymphopenia; 11.5 months (95%CI = 9.8 to 13.9 months), and 21.2 months (95%CI = 9.9 to 55.3 months), for intermediate-(patient with sarcopenia without lymphopenia), and low-risk groups (no risk factor), respectively (p &lt;0.001). Preoperative sarcopenia predicts the occurrence of postoperative lymphopenia in patients with a preoperative lymphocyte count above 1,000/mm3 (p = 0.0029).ConclusionsPreoperative lymphopenia and sarcopenia are pejorative prognostic factors in LPDAC and should be considered in the preoperative evaluation to stratify death risk in patients with LPDAC.

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