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Predictive risk factors for peritoneal recurrence after pancreatic cancer resection and strategies for its prevention
- Source :
- Surgery today. 47(12)
- Publication Year :
- 2017
-
Abstract
- To evaluate the risk factors for peritoneal recurrence (PR) of pancreatic adenocarcinoma and to discuss the appropriate management strategies. We reviewed the medical records of 236 patients who underwent pancreatectomy for pancreatic adenocarcinoma. We then compared the clinicopathological characteristics of patients with vs. those without PR. The independent risk factors for PR were defined using the Cox proportional hazards regression model. The median survival of patients with PR was 13.3 months after surgical treatment. The PR group had a significantly higher incidence of portal vein resection, longer operative time (≥648 min), greater blood loss (≥2179 mL), blood transfusion, tumor size, portal vein invasion, artery invasion, pancreatic nerve plexus invasion, and histological grade. Multivariate analysis revealed that excessive blood loss (≥2179 mL; P = 0.010), artery invasion (P = 0.025), pancreatic nerve plexus invasion (P = 0.001), and histological grade 3 (P = 0.011) were independent risk factors for PR. Excessive blood loss was also strongly related to tumor size (P = 0.018). Local invasion and tumor size-related factors suggested the possibility of intraoperative dissemination at the time of tumor resection. Preoperative treatment and an operative procedure to prevent tumor exposure may help prevent PR.
- Subjects :
- Male
medicine.medical_specialty
Blood transfusion
medicine.medical_treatment
Operative Time
Blood Loss, Surgical
Adenocarcinoma
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Pancreatectomy
Surgical oncology
Risk Factors
Pancreatic cancer
Internal medicine
medicine
Humans
Blood Transfusion
Neoplasm Invasiveness
Pancreas
Aged
Neoplasm Staging
Proportional Hazards Models
business.industry
Portal Vein
Medical record
Incidence (epidemiology)
General Medicine
Arteries
medicine.disease
Prognosis
Pancreatic Neoplasms
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Surgery
Female
Neoplasm Recurrence, Local
Peritoneum
business
Artery
Subjects
Details
- ISSN :
- 14362813
- Volume :
- 47
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Surgery today
- Accession number :
- edsair.doi.dedup.....ba1026bfb3f3ff172127b6c166f488ba