Erschienen in:
06.11.2020 | Pancreatic Tumors
The Oncologic Impact of Pancreatic Fistula After Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma of the Body and the Tail: A Multicenter Retrospective Cohort Analysis
verfasst von:
Piera Leon, MD, Fabio Giannone, MD, Giulio Belfiori, MD, Massimo Falconi, MD, PhD, Stefano Crippa, MD, PhD, Ugo Boggi, MD, PhD, Francesca Menonna, MD, Abdul Rahman Al Sadairi, MD, Tullio Piardi, MD, PhD, Laurent Sulpice, MD, PhD, Andrea Gardini, MD, PhD, Valentina Sega, MD, Mircea Chirica, MD, PhD, Ferruccio Ravazzoni, MD, Giusy Giannandrea, MD, Patrick Pessaux, MD, PhD, Vito de Blasi, MD, Francis Navarro, MD, PhD, Fabrizio Panaro, MD, PhD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 6/2021
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Abstract
Objectives
The aim of this study was to assess the impact of clinically relevant postoperative pancreatic fistula (CR-POPF) on patient disease-specific survival and recurrence after curative distal pancreatectomy (DP) for pancreatic cancer.
Design
This was a retrospective case-control analysis.
Methods
We examined the data of adult patients with a diagnosis of pancreatic ductal adenocarcinoma (PDAC) of the body and tail of the pancreas undergoing curative DP, over a 10-year period in 12 European surgical departments, from a prospectively implemented database.
Results
Among the 382 included patients, 283 met the strict inclusion criteria; 139 were males (49.1%) and the median age of the entire population was 70 years (range 37–88). A total of 121 POPFs were observed (42.8%), 42 (14.9%) of which were CR-POPFs. The median follow-up period was 24 months (range 3–120). Although poorer in the POPF group, overall survival (OS) and disease-free survival (DFS) did not differ significantly between patients with and without CR-POPF (p = 0.224 and p = 0.165, respectively). CR-POPF was not significantly associated with local or peritoneal recurrence (p = 0.559 and p = 0.302, respectively). A smaller percentage of patients benefited from adjuvant chemotherapy after POPF (76.2% vs. 83.8%), but the difference was not significant (p = 0.228).
Conclusions
CR-POPF is a major complication after DP but it did not affect the postoperative therapeutic path or long-term oncologic outcomes. CR-POPF was not a predictive factor for disease recurrence and was not associated with an increased incidence of peritoneal or local relapse.
Trial Registration
ClinicalTrials.gov ID: NCT04348084