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Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy.

Publication ,  Journal Article
Cheng, T-Y; Sheth, K; White, RR; Ueno, T; Hung, C-F; Clary, BM; Pappas, TN; Tyler, DS
Published in: Ann Surg Oncol
January 2006

BACKGROUND: Neoadjuvant chemoradiotherapy (neo-CRT) is being used with increasing frequency for periampullary tumors, but how it alters the complication rate of pancreaticoduodenectomy (PD) is unclear. METHODS: A retrospective analysis was conducted of 79 patients with periampullary malignancies who received 5-fluorouracil-based neo-CRT followed by PD. RESULTS: There was no difference in mortality between PD after neo-CRT (3.8%) and conventional PD for either malignant (4.5%) or benign (2.2%) disease. Focusing only on patients with malignancy, the neo-CRT group had a significantly lower pancreatic leak rate than the conventional group (10% vs. 43%; P < .001). Intra-abdominal abscesses were less common in the neo-CRT group (8.8% vs. 21%; P = .019), and there was one (1.2%) amylase-rich abscess in neo-CRT group, compared with eight (12%) in the conventional group. In addition, two patients in the conventional group died of leak-associated sepsis, compared with none in the neo-CRT group. Multivariate analysis revealed that neoadjuvant chemoradiation (odds ratio, .15) was the most significant factor associated with a reduced risk of pancreatic leak. CONCLUSIONS: Neo-CRT does not increase the mortality or morbidity of PD. In contrast, neo-CRT was associated with a marked reduction in the incidence of pancreatic leak, as well as leak-associated morbidity and mortality.

Duke Scholars

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Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

January 2006

Volume

13

Issue

1

Start / End Page

66 / 74

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Cheng, T.-Y., Sheth, K., White, R. R., Ueno, T., Hung, C.-F., Clary, B. M., … Tyler, D. S. (2006). Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol, 13(1), 66–74. https://doi.org/10.1245/ASO.2006.02.003
Cheng, Tsung-Yen, Ketan Sheth, Rebekah R. White, Tomio Ueno, Cheng-Fang Hung, Bryan M. Clary, Theodore N. Pappas, and Douglas S. Tyler. “Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy.Ann Surg Oncol 13, no. 1 (January 2006): 66–74. https://doi.org/10.1245/ASO.2006.02.003.
Cheng T-Y, Sheth K, White RR, Ueno T, Hung C-F, Clary BM, et al. Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol. 2006 Jan;13(1):66–74.
Cheng, Tsung-Yen, et al. “Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy.Ann Surg Oncol, vol. 13, no. 1, Jan. 2006, pp. 66–74. Pubmed, doi:10.1245/ASO.2006.02.003.
Cheng T-Y, Sheth K, White RR, Ueno T, Hung C-F, Clary BM, Pappas TN, Tyler DS. Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol. 2006 Jan;13(1):66–74.
Journal cover image

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

January 2006

Volume

13

Issue

1

Start / End Page

66 / 74

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Postoperative Complications
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male