The role of surgery for pancreatic cancer: a 12-year review of patient outcome.

Hdl Handle:
http://hdl.handle.net/10147/207395
Title:
The role of surgery for pancreatic cancer: a 12-year review of patient outcome.
Authors:
Badger, S A; Brant, J L; Jones, C; McClements, J; Loughrey, M B; Taylor, M A; Diamond, T; McKie, L D
Affiliation:
Hepatobiliary Surgical Unit, Mater Hospital, Belfast Health and Social Care, Trust, Crumlin Road, Belfast BT14 6AB. stephenbadger@btinternet.com
Citation:
Ulster Med J. 2010 May;79(2):70-5.
Journal:
The Ulster medical journal
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207395
PubMed ID:
21116422
Abstract:
INTRODUCTION: Pancreatic cancer has a poor prognosis with <5% alive at 5 years, despite active surgical treatment. The study aim was to review patients undergoing pancreatic resection and assess the effect of clinical and pathological parameters on survival. PATIENTS AND METHODS: All patients who had undergone radical pancreatic surgery, January 1996 to December 2008, were identified from the unit database. Additional information was retrieved from the patient records. The demographic, clinical, and pathological records were recorded using Microsoft Excel. Survival was assessed using Kaplan-Meier and predictors of survival determined by multinominal logistic regression and log rank test. RESULTS: 126 patients were identified from the database. The majority (106) had a Whipple's procedure, 14 had a distal pancreatectomy and 6 had local periampullary excision. The average age of the Whipple's group of patients was 61.7 years (+/- 11.7) with most procedures performed for malignancy (n=100). Survival was worse with adenocarcinoma compared to all other pathologies (p=0.013), while periampullary tumours had a better prognosis compared to other locations (p=0.019). Survival decreased with poorer differentiation (p=0.001), increasing pT (p<0.001) and pN stage (p<0.001). Survival was worse with perineural (p=0.04) or lymphovascular invasion (p=0.05). A microscopic postive resection margin (R1) was associated with a worse survival (p=0.007). Tumour differentiation (p=0.001) and positive nodal status (p<0.001) were found to be independent predictors of mortality. CONCLUSION: Tumour differentiation and nodal status are important predictors of outcome. A positive resection margin is associated with a poorer survival.
Language:
eng
MeSH:
Adenocarcinoma/mortality/pathology/secondary/*surgery; Adult; Aged; Aged, 80 and over; Endocrine Gland Neoplasms/mortality/pathology/*surgery; Female; Humans; Kaplan-Meier Estimate; Logistic Models; Lymphatic Metastasis; Male; Middle Aged; *Pancreatectomy; Pancreatic Neoplasms/mortality/pathology/*surgery; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome
ISSN:
0041-6193 (Print); 0041-6193 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBadger, S Aen_GB
dc.contributor.authorBrant, J Len_GB
dc.contributor.authorJones, Cen_GB
dc.contributor.authorMcClements, Jen_GB
dc.contributor.authorLoughrey, M Ben_GB
dc.contributor.authorTaylor, M Aen_GB
dc.contributor.authorDiamond, Ten_GB
dc.contributor.authorMcKie, L Den_GB
dc.date.accessioned2012-02-01T10:23:54Z-
dc.date.available2012-02-01T10:23:54Z-
dc.date.issued2012-02-01T10:23:54Z-
dc.identifier.citationUlster Med J. 2010 May;79(2):70-5.en_GB
dc.identifier.issn0041-6193 (Print)en_GB
dc.identifier.issn0041-6193 (Linking)en_GB
dc.identifier.pmid21116422en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207395-
dc.description.abstractINTRODUCTION: Pancreatic cancer has a poor prognosis with <5% alive at 5 years, despite active surgical treatment. The study aim was to review patients undergoing pancreatic resection and assess the effect of clinical and pathological parameters on survival. PATIENTS AND METHODS: All patients who had undergone radical pancreatic surgery, January 1996 to December 2008, were identified from the unit database. Additional information was retrieved from the patient records. The demographic, clinical, and pathological records were recorded using Microsoft Excel. Survival was assessed using Kaplan-Meier and predictors of survival determined by multinominal logistic regression and log rank test. RESULTS: 126 patients were identified from the database. The majority (106) had a Whipple's procedure, 14 had a distal pancreatectomy and 6 had local periampullary excision. The average age of the Whipple's group of patients was 61.7 years (+/- 11.7) with most procedures performed for malignancy (n=100). Survival was worse with adenocarcinoma compared to all other pathologies (p=0.013), while periampullary tumours had a better prognosis compared to other locations (p=0.019). Survival decreased with poorer differentiation (p=0.001), increasing pT (p<0.001) and pN stage (p<0.001). Survival was worse with perineural (p=0.04) or lymphovascular invasion (p=0.05). A microscopic postive resection margin (R1) was associated with a worse survival (p=0.007). Tumour differentiation (p=0.001) and positive nodal status (p<0.001) were found to be independent predictors of mortality. CONCLUSION: Tumour differentiation and nodal status are important predictors of outcome. A positive resection margin is associated with a poorer survival.en_GB
dc.language.isoengen_GB
dc.subject.meshAdenocarcinoma/mortality/pathology/secondary/*surgeryen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshEndocrine Gland Neoplasms/mortality/pathology/*surgeryen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshKaplan-Meier Estimateen_GB
dc.subject.meshLogistic Modelsen_GB
dc.subject.meshLymphatic Metastasisen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.mesh*Pancreatectomyen_GB
dc.subject.meshPancreatic Neoplasms/mortality/pathology/*surgeryen_GB
dc.subject.meshPrognosisen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshSurvival Rateen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.titleThe role of surgery for pancreatic cancer: a 12-year review of patient outcome.en_GB
dc.contributor.departmentHepatobiliary Surgical Unit, Mater Hospital, Belfast Health and Social Care, Trust, Crumlin Road, Belfast BT14 6AB. stephenbadger@btinternet.comen_GB
dc.identifier.journalThe Ulster medical journalen_GB
dc.description.provinceLeinster-

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