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Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.

Publication ,  Journal Article
Pugalenthi, A; Protic, M; Gonen, M; Kingham, TP; Angelica, MID; Dematteo, RP; Fong, Y; Jarnagin, WR; Allen, PJ
Published in: J Surg Oncol
February 2016

INTRODUCTION: Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40-50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. METHODS: A total of 596 patients that underwent PD for PDA between 2001 and 2009 were identified from a prospective database. Complications were defined and graded (1-5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥grade 3. Postoperative mortality (≤90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. RESULTS: Median survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n = 129). Our 90 day mortality was 3.7% (n = 22). Anastomotic fistula/leak/abscess rate was 14% (n = 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) >600 ml, length of stay (LOS) >10 days, margin positivity, and vascular procedures as predictors of decreased overall survival (P < 0.05). High grade complications were not associated with overall survival (P = 0.948). CONCLUSION: In this study, the occurrence of high grade postoperative complications was not associated with overall survival.

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Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

February 2016

Volume

113

Issue

2

Start / End Page

188 / 193

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Proportional Hazards Models
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lymphatic Metastasis
 

Citation

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Pugalenthi, A., Protic, M., Gonen, M., Kingham, T. P., Angelica, M. I. D., Dematteo, R. P., … Allen, P. J. (2016). Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol, 113(2), 188–193. https://doi.org/10.1002/jso.24125
Pugalenthi, Amudhan, Mladjan Protic, Mithat Gonen, T Peter Kingham, Michael I D’ Angelica, Ronald P. Dematteo, Yuman Fong, William R. Jarnagin, and Peter J. Allen. “Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.J Surg Oncol 113, no. 2 (February 2016): 188–93. https://doi.org/10.1002/jso.24125.
Pugalenthi A, Protic M, Gonen M, Kingham TP, Angelica MID, Dematteo RP, et al. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016 Feb;113(2):188–93.
Pugalenthi, Amudhan, et al. “Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.J Surg Oncol, vol. 113, no. 2, Feb. 2016, pp. 188–93. Pubmed, doi:10.1002/jso.24125.
Pugalenthi A, Protic M, Gonen M, Kingham TP, Angelica MID, Dematteo RP, Fong Y, Jarnagin WR, Allen PJ. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016 Feb;113(2):188–193.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

February 2016

Volume

113

Issue

2

Start / End Page

188 / 193

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Proportional Hazards Models
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lymphatic Metastasis