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

BMC Surgery

Research Article

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

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

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

DOI  :  10.1186/1471-2482-13-12

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

来源: Springer

【 摘 要 】

BackgroundSurgery 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.MethodsThe 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.ResultsThe 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.ConclusionsOur 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】

CC BY   
© Distler et al.; licensee BioMed Central Ltd. 2013