Severe postoperative complications decrease overall and disease free survival in pancreatic ductal adenocarcinoma after pancreaticoduodenectomy

Publication date: Available online 10 April 2018
Source:European Journal of Surgical Oncology
Author(s): Jean Lubrano, Philippe Bachelier, François Paye, Yves Patrice Le Treut, Laurence Chiche, Antonio Sa-Cunha, Olivier Turrini, Benjamin Menahem, Guy Launoy, Jean-Robert Delpero
BackgroundPostoperative complications influence overall and disease free survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma is still a matter of debate and controversy.MethodsThe outcome of 942 consecutive patients, from the multicentric study of the French Association of Surgery, between January 2004 and December 2009 was analyzed. Perioperative data, including severe complications (grade III and above), were used in univariate and multivariate analysis to assess their influence on overall and disease free survival. Recurrence and its location were investigated as well.ResultsMedian overall and disease free survival were 24 and 19 months respectively. Postoperative complications occurred in 444 patients (47%) with 18.3% of severe complications. On multivariate analysis, severe complications, positive lymph node status and R1-R2 resection were independent prognostic factors for both overall and disease free survival. The median overall survival decreased from 25 to 22 months (p=0.005) and disease free survival from 21 to 16 months (p=0.02) if severe complications occurred. Severe complications were independent prognostic factor of recurrence (p<0.001).ConclusionsSevere complications significantly alter both overall and disease free survival and are an independent factor of recurrence.



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