Survival after resection of pancreatic adenocarcinoma: Results from a single institution over three decades Journal Article
| Authors: | Winter, J. M.; Brennan, M. F.; Tang, L. H.; D'Angelica, M. I.; DeMatteo, R. P.; Fong, Y.; Klimstra, D. S.; Jarnagin, W. R.; Allen, P. J. |
| Article Title: | Survival after resection of pancreatic adenocarcinoma: Results from a single institution over three decades |
| Abstract: | Background: Randomized trials have demonstrated a benefit associated with adjuvant therapy for pancreatic cancer, and retrospective studies have demonstrated improvements in postoperative mortality. The purpose of this study was to evaluate whether these improvements could be identified in a cohort of patients who underwent resection for pancreatic cancer at a single institution over three decades. Methods: Short- (30 days), intermediate- (1 year), and long-term survival were compared between decades. Long-term survival focused on patients who survived at least 1 year to minimize the effects of perioperative mortality and patient selection. Results: Between 1983 and 2009, 1147 pancreatic resections were performed for ductal adenocarcinoma, including 123 resections in the 1980s, 399 in the 1990s, and 625 in the 2000s. The 30-day mortality rates were 4.9%, 1.5% (P = 0.03 vs. 1980s), and 1.3% (P = 0.007 vs. 1980s). The 1-year mortality rates were 42%, 31% (P < 0.001 vs. 1980s), and 24% (P < 0.001 vs. 1980s and 1990s). In the group of patients who survived 1 year, the overall survivals were 23.2 months, 25.6 months (P = 0.6 vs. 1980s), and 24.5 months (P = 0.2 vs. 1980s). In a multivariate analysis adjusted for pathologic features, the decade of resection was not a significant predictor of long-term survival (hazard ratio = 1.1, P = 0.3). Conclusions: Patients who underwent resection for pancreatic cancer between 2000 and 2009 experienced improved operative mortality and 1-year survival compared to those who underwent resection in the 1980s, while the long-term survival was similar over all three decades. These results underscore the need for early detection strategies and more effective adjuvant therapies for patients with pancreatic cancer. © 2011 Society of Surgical Oncology. |
| Keywords: | treatment outcome; cancer surgery; survival rate; major clinical study; overall survival; mortality; pancreas resection; pancreas adenocarcinoma; multivariate analysis; kaplan meier method |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 19 |
| Issue: | 1 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2012-01-01 |
| Start Page: | 169 |
| End Page: | 175 |
| Language: | English |
| DOI: | 10.1245/s10434-011-1900-3 |
| PROVIDER: | scopus |
| PUBMED: | 21761104 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 1 March 2012" - "CODEN: ASONF" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work