Methods
Patients and Design
Surgical Technique and Oncologic Treatment Regimen
Definitions
Outcomes and Data Collection
Statistical Analysis
Results
Patient Characteristics
Male sex | 63 (45) |
Age [years; mean (SD)] | 64 (10) |
BMI [kg/m2; mean (SD)] | 25 (4) |
ASA physical status | |
1 | 16 (11) |
2 | 99 (70) |
3 | 23 (16) |
4 | 3 (2) |
Previous abdominal surgery | 53 (38) |
Other organs involved on CT/MRI | 29 (21) |
Stomach | 9 (6) |
Spleen | 7 (5) |
Kidney | 4 (3) |
Intestine | 4 (3) |
Two or more adjacent organs | 5 (4) |
Intraoperative and Pathology Outcomes
Splenectomy | 124 (88) |
Multivisceral resection | 43 (30) |
Stomach | 9 (6) |
Intestine | 5 (4) |
Kidney/adrenal gland | 5 (4) |
Vessel resection | 5 (4) |
Other | 4 (3) |
>1 additional resection | 15 (11) |
Procedure time [min; median (IQR)] | 194 (150–270) |
Blood loss [min; median (IQR)] | 800 (495–1618) |
Tumor size [mm; mean (SD)] | 44 (23) |
Resection margins | |
R0 | 70 (50) |
R0 in multivisceral resection | 17 (40) |
R1 | 64 (45) |
R2 | 7 (5) |
Lymph nodes resected [median (IQR)] | 8 (4–14) |
Positive lymph nodes resected [mean (SD)] | 1 (1) |
pT stage | |
1 | 14 (10) |
2 | 70 (50) |
3 | 52 (37) |
4 | 5 (4) |
pN1 stage | 74 (53) |
pM1 stage | 4 (3) |
Cancer stage | |
1A | 6 (4) |
1B | 34 (24) |
2A | 25 (18) |
2B | 68 (48) |
3 | 4 (3) |
4 | 4 (3) |
Postoperative Outcomes
Major complications | 46 (33) |
Clavien–Dindo 3 | 35 (25) |
Clavien–Dindo 4 | 5 (4) |
Clavien–Dindo 5 | 6 (4) |
Postoperative pancreatic fistula grade B/C | 24 (17) |
Delayed gastric emptying grade B/C | 25 (18) |
Postpancreatectomy hemorrhage grade B/C | 6 (4) |
Surgical site infection | 18 (13) |
Intensive care unit admission | 24 (17) |
Length of intensive care unit stay [days; median (IQR)] | 2 (2–8) |
Length of stay [days; median (IQR)] | 10 (8–15) |
Readmission within 30 days | 25 (18) |
Adjuvant chemotherapy | 63 (45) |
Mortality ≤30 days postoperatively | 4 (3) |
Mortality ≤90 days postoperatively | 9 (6) |
Survival
Variable | Univariable analysis | Multivariable analysis | ||
---|---|---|---|---|
HR (95 % CI) |
p value | HR (95 % CI) |
p value | |
Female sex | 0.88 (0.59–1.31) | 0.52 | – | – |
Age > 70 years | 1.30 (0.85–1.99) | 0.22 | – | – |
ASA physical status 3/4 | 1.06 (0.64–1.77) | 0.82 | – | – |
Tumor size (cm) | 1.03 (0.96–1.11) | 0.39 | – | – |
Laparoscopic approach | 1.31 (0.57–3.00) | 0.52 | – | – |
Multivisceral resection | 2.04 (1.35–3.09) | <0.01 | –a
| –a
|
R1/R2 resection | 1.81 (1.22–2.70) | <0.01 | 1.61 (1.08–2.41) | 0.02 |
No. of tumor-positive lymph nodes | 1.06 (0.94–1.18) | 0.35 | – | – |
pN1 stage | 1.41 (0.95–2.10) | 0.09 | –a
| –a
|
pT3/pT4 stage | 3.84 (1.71–8.60) | <0.01 | 1.92 (1.29–2.88) | <0.01 |
Major complication | 1.74 (1.16–2.62) | 0.01 | 1.67 (1.10–2.51) | 0.02 |
No adjuvant therapy | 1.89 (1.23–2.90) | <0.01 | 1.51 (1.01–2.26) | 0.045 |