Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma

BMC Surgery

Robert Grützmann¹  Hans-Detlev Saeger¹  Christian Pilarsky¹  Stephan Kersting¹  Maximilian Hunger¹  Felix Rückert²  Marius Distler¹ 

[1] Department of General, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstrasse 74, Dresden 01307, Germany;Surgical Department, University Hospital Mannheim, Heidelberg University, Mannheim, Germany

关键词: Pylorus-preserving pancreatoduodenectomy (PPPD);    Whipple procedure;    Surgery;    Tumor marker;    Pancreatic cancer;   

Others  :  866933
DOI  :  10.1186/1471-2482-13-12

 received in 2012-09-12, accepted in 2013-03-26,  发布年份 2013

【 摘 要 】

Background

Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma (PDAC). The goal of this study was to investigate the clinical outcome and prognostic factors in patients after resection for ductal adenocarcinoma of the pancreatic head.

Methods

The data from 195 patients who underwent pancreatic head resection for PDAC between 1993 and 2011 in our center were retrospectively analyzed. The prognostic factors for survival after operation were evaluated using multivariate analysis.

Results

The head resection surgeries included 69.7% pylorus-preserving pancreatoduodenectomies (PPPD) and 30.3% standard Kausch-Whipple pancreatoduodenectomies (Whipple). The overall mortality after pancreatoduodenectomy (PD) was 4.1%, and the overall morbidity was 42%. The actuarial 3- and 5-year survival rates were 31.5% (95% CI, 25.04%-39.6%) and 11.86% (95% CI, 7.38%-19.0%), respectively. Univariate analyses demonstrated that elevated CEA (p = 0.002) and elevated CA 19–9 (p = 0.026) levels, tumor grade (p = 0.001) and hard texture of the pancreatic gland (p = 0.017) were significant predictors of a poor survival. However, only CEA >3 ng/ml (p < 0.005) and tumor grade 3 (p = 0.027) were validated as significant predictors of survival in multivariate analysis.

Conclusions

Our results suggest that tumor marker levels and tumor grade are significant predictors of poor survival for patients with pancreatic head cancer. Furthermore, hard texture of the pancreatic gland appears to be associated with poor survival.

【 授权许可】

   
2013 Distler et al.; licensee BioMed Central Ltd.

【 图 表 】

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