Postoperative pancreatic fistula affects recurrence-free survival of pancreatic cancer patients

Autor: Laura Kerschke, Marius Jacob, Norbert Senninger, Georg Ebeling, Sameer A. Dhayat, Iyad Kabar, Ahmad N J Tamim
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Epidemiology
Cancer Treatment
Gastroenterology
Mathematical and Statistical Techniques
0302 clinical medicine
Risk Factors
Medicine and Health Sciences
Clinical endpoint
Postoperative Period
Multidisciplinary
Incidence
Cancer Risk Factors
Incidence (epidemiology)
Statistics
Middle Aged
Tumor Resection
Hospitals
Surgical Oncology
Oncology
Pancreatic fistula
030220 oncology & carcinogenesis
Physical Sciences
Resection margin
Regression Analysis
Medicine
030211 gastroenterology & hepatology
Research Article
Adult
Clinical Oncology
medicine.medical_specialty
Science
Surgical and Invasive Medical Procedures
Gastroenterology and Hepatology
Research and Analysis Methods
Pancreatic Fistula
Pancreatic Cancer
03 medical and health sciences
Internal medicine
Pancreatic cancer
Gastrointestinal Tumors
medicine
Humans
Statistical Methods
Aged
Retrospective Studies
Surgical Resection
business.industry
Proportional hazards model
Cancers and Neoplasms
Perioperative
medicine.disease
Pancreatic Neoplasms
Health Care
Pancreatitis
Health Care Facilities
Medical Risk Factors
Clinical Medicine
business
Body mass index
Mathematics
Zdroj: PLoS ONE, Vol 16, Iss 6, p e0252727 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Purpose Postoperative pancreatic fistula (POPF) with reported incidence rates up to 45% contributes substantially to overall morbidity. In this study, we conducted a retrospective evaluation of POPF along with its potential perioperative clinical risk factors and its effect on tumor recurrence. Methods Clinical data on patients who had received pancreatoduodenectomy (PD), distal pancreatectomy (DP), or duodenum-preserving pancreatic head resection (DPPHR) were prospectively collected between 2007 and 2016. A Picrosirius red staining score was developed to enable morphological classification of the resection margin of the pancreatic stump. The primary end point was the development of major complications. The secondary end points were overall and recurrence-free survival. Results 340 patients underwent pancreatic resection including 222 (65.3%) PD, 87 (25.6%) DP, and 31 (9.1%) DPPHR. Postoperative major complications were observed in 74 patients (21.8%). In multivariable logistic regression analysis, POPF correlated with body mass index (BMI) (p = 0.025), prolonged stay in hospital (p Conclusion Besides the known clinicopathological risk factors BMI and amylase in the drain fluid, the incidence of POPF correlates with high Picrosirius red staining score in the resection margins of the pancreatic stumps of curatively resected pancreatic ductal adenocarcinoma (PDAC). Furthermore, clinically relevant POPF seems to be a prognostic factor for tumor recurrence in PDAC.
Databáze: OpenAIRE
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