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Survival after pancreaticoduodenectomy for periampullary adenocarcinoma: an update
- Source :
- European journal of surgical oncology, 27(6), 549-557. W.B. Saunders Ltd
- Publication Year :
- 2001
-
Abstract
- Aim: Survival after pancreaticoduodenectomy for periampullary tumours is limited. Over the last decade peri-operative management has improved and morbidity and mortality decreased. The aim of the study was to analyse recent survival data after pancreaticoduodenectomy and to determine factors that influence survival. Methods: From October 1992 to September 1998, 204 patients with a ductal adenocarcinoma in the pancreatic head (108), distal bile duct (32), and ampulla (64) who underwent standard pancreaticoduodenectomy, were analysed with regard to histology and tumour status. Survival was calculated by using the Kaplan–Meier method. Risk factors were identified in a univariate and multivariate analysis. Results: Median survival after resection for carcinoma of the pancreatic head, distal bile duct, and ampulla were 16*, 25 and 24* months, respectively (* P =0.008). In the univariate analysis vein resection, blood transfusion of more than four packed red cells, the presence of tumour positive resection margins, lymph-node metastases and poor tumour differentiation significantly decreased survival. In the multivariate analysis positive resection margins, lymph-node metastases, and poor tumour differentiation independently influenced survival. Conclusions: Resection margins, lymph-node status and tumour differentiation are independent prognostic factors. Survival after standard pancreaticoduodenectomy for periampullary tumours has not improved.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Gastroenterology
Pancreaticoduodenectomy
Cohort Studies
Age Distribution
Risk Factors
Internal medicine
Carcinoma
Medicine
Humans
Sex Distribution
Survival analysis
Aged
Neoplasm Staging
Probability
Proportional Hazards Models
Retrospective Studies
Aged, 80 and over
Univariate analysis
business.industry
Bile duct
General Medicine
Middle Aged
medicine.disease
Survival Analysis
Pancreatic Neoplasms
medicine.anatomical_structure
Periampullary Adenocarcinoma
Treatment Outcome
Oncology
Multivariate Analysis
Adenocarcinoma
Surgery
Female
business
Pancreas
Carcinoma, Pancreatic Ductal
Subjects
Details
- Language :
- English
- ISSN :
- 07487983
- Database :
- OpenAIRE
- Journal :
- European journal of surgical oncology, 27(6), 549-557. W.B. Saunders Ltd
- Accession number :
- edsair.doi.dedup.....1aa4ca1399d792dceaec1afe4a1b290f