Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 4/2014

01.04.2014 | Gastrointestinal Oncology

Outcome Quality Standards in Pancreatic Oncologic Surgery

verfasst von: Luis Sabater, PhD, Alvaro García-Granero, MD, Javier Escrig-Sos, PhD, Maria del Carmen Gómez-Mateo, MD, Juan Sastre, PhD, Antonio Ferrández, PhD, Joaquín Ortega, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To identify quality indicators and establish acceptable quality limits (AQLs) in pancreatic oncologic surgery using a formal statistical methodology.

Methods

Indicators have been identified through systematic literature reviews and guidelines for pancreatic surgery. AQLs were determined for each indicator with confidence intervals of 99.8 and 95 % above and below the weighted average by sample size from the different series examined.

Results

Several indicators have been identified with the following results as AQLs: resectability rate >59 %; morbidity, mortality, and pancreatic fistula rate in pancreaticoduodenectomy <55, <5, and <16 %, respectively; morbidity, mortality, and fistula rate in distal pancreatectomy <53, <4, and <31 %, respectively; number of lymph nodes retrieved >15; R1 resection <46 %; survival at 1, 3, and 5 years >54, >19, and >8 %, respectively.

Conclusions

A series of different indicators for quality surgical care outcome in pancreatic cancer, as well as their limits, have been determined according to a standard methodology.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
2.
Gouma DJ, van Geenen RC, van Gulik TM, de Haan RJ, de Wit LT, Busch OR, Obertop H. Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann Surg. 2000;232:786–95.PubMedCentralPubMed
3.
Balzano G, Zerbi A, Capretti G, Rocchetti S, Capitanio V, Di Carlo V. Effect of hospital volume on outcome of pancreaticoduodenectomy in Italy. Br J Surg. 2008;95:357–62.PubMed
4.
Schmidt CM, Turrini O, Parikh P, et al. Effect of hospital volume, surgeon experience, and surgeon volume on patient outcomes after pancreaticoduodenectomy: a single-institution experience. Arch Surg. 2010;145:634–40.PubMed
5.
Brennan MF. Quality pancreatic cancer care: it’s still mostly about volume. J Natl Cancer Inst. 2009;101:837–8.PubMed
6.
Gooiker GA, van Gijn W, Wouters MW, Post PN, van de Velde CJ, Tollenaar RA; Signalling Committee Cancer of the Dutch Cancer Society. Systematic review and meta-analysis of the volume-outcome relationship in pancreatic surgery. Br J Surg. 2011;98:485–94.PubMed
7.
8.
Spiegelhalter DJ. Funnel plots for comparing institutional performance. Statist Med. 2005;24:1185–202.
9.
Tempero MA, Behrman S, Ben-Josef E, et al.; National Comprehensive Cancer Network. Pancreatic adenocarcinoma: clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2005;3:598–626.PubMed
10.
Tempero MA, Arnoletti JP, Behrman SW, et al.; National Comprehensive Cancer Networks. Pancreatic Adenocarcinoma, version 2.2012: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw. 2012;10:703–13.PubMedCentralPubMed
11.
Van Laethem JL, Verslype C, Iovanna JL, et al. New strategies and designs in pancreatic cancer research: consensus guidelines report from a European expert panel. Ann Oncol. 2012;23:570–6.PubMed
12.
Yamaguchi K, Tanaka M, Committee for Revision of Clinical Guidelines for Pancreatic Cancer of Japan Pancreas Society. EBM-based Clinical Guidelines for Pancreatic Cancer 2009 from the Japan Pancreas Society: a synopsis. Jpn J Clin Oncol. 2011;41:836–40.PubMed
13.
Cascinu S, Falconi M, Valentini V, Jelic S; ESMO Guidelines Working Group. Pancreatic cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21 Suppl 5:v55–8.PubMed
14.
Ujiki MB, Talamonti MS. Guidelines for the surgical management of pancreatic adenocarcinoma. Semin Oncol. 2007;34:311–20.PubMed
15.
Pancreatric Section, British Society of Gastroenterology; Pancreatic Society of Great Britain and Ireland; Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland; Royal College of Pathologists; Special Interest Group for Gastro-Intestinal Radiology. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas. Gut. 2005; 54 Suppl 5:v1–16.
16.
Evans DB, Jessup JM, Colacchio T. Pancreatic cancer surgical practice guidelines. Pancreatic Cancer Practice Guideline Committee. Oncology (Williston Park). 1997;11:1074–9.
17.
Saldinger PF, Reilly M, Reynolds K, Raptopoulos V, Chuttani R, Steer ML, Matthews JB. Is CT angiography sufficient for prediction of resectability of periampullary neoplasms? J Gastrointest Surg. 2000;4:233–7.PubMed
18.
Valls C, Andía E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR Am J Roentgenol. 2002;178:821–6.PubMed
19.
Minniti S, Bruno C, Biasiutti C, Tonel D, Falzone A, Falconi M, Procacci C. Sonography versus helical CT in identification and staging of pancreatic ductal adenocarcinoma. J Clin Ultrasound. 2003;31:175–82.PubMed
20.
Vargas R, Nino-Murcia M, Trueblood W, Jeffrey RB Jr. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol. 2004;182:419–25.PubMed
21.
Maire F, Sauvanet A, Trivin F, et al. Staging of pancreatic head adenocarcinoma with spiral CT and endoscopic ultrasonography: an indirect evaluation of the usefulness of laparoscopy. Pancreatology. 2004;4:436–40.PubMed
22.
Meszoely IM, Wang H, Hoffman JP. Preoperative chemoradiation therapy for adenocarcinoma of the pancreas: The Fox Chase Cancer Center experience, 1986–2003. Surg Oncol Clin N Am. 2004;13:685–96.PubMed
23.
House MG, Yeo CJ, Cameron JL, et al. Predicting resectability of periampullary cancer with three-dimensional computed tomography. J Gastrointest Surg. 2004;8:280–8.PubMed
24.
Soriano A, Castells A, Ayuso C, et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 2004;99:492–501.PubMed
25.
Borbath I, Van Beers BE, Lonneux M, Schoonbroodt D, Geubel A, Gigot JF, Deprez PH. Preoperative assessment of pancreatic tumors using magnetic resonance imaging, endoscopic ultrasonography, positron emission tomography and laparoscopy. Pancreatology 2005;5:553–61.PubMed
26.
Karmazanovsky G, Fedorov V, Kubyshkin V, Kotchatkov A. Pancreatic head cancer: accuracy of CT in determination of resectability. Abdom Imaging. 2005;30:488–500.PubMed
27.
Olivié D, Lepanto L, Billiard JS, Audet P, Lavallée JM. Predicting resectability of pancreatic head cancer with multi-detector CT. Surgical and pathologic correlation. JOP. 2007;8:753–8.PubMed
28.
Zamboni GA, Kruskal JB, Vollmer CM, Baptista J, Callery MP, Raptopoulos VD. Pancreatic adenocarcinoma: value of multidetector CT angiography in preoperative evaluation. Radiology. 2007;245:770–8.PubMed
29.
Yamada S, Takeda S, Fujii T, et al. Clinical implications of peritoneal cytology in potentially resectable pancreatic cancer: positive peritoneal cytology may not confer an adverse prognosis. Ann Surg. 2007;246:254–8.PubMedCentralPubMed
30.
Bao PQ, Johnson JC, Lindsey EH, et al. Endoscopic ultrasound and computed tomography predictors of pancreatic cancer resectability. J Gastrointest Surg. 2008;12:10–6.PubMed
31.
Ong SL, Garcea G, Thomasset SC, et al. Surrogate markers of resectability in patients undergoing exploration of potentially resectable pancreatic adenocarcinoma. J Gastrointest Surg. 2008;12:1068–73.PubMed
32.
Ho JM, Eysselein VE, Stabile BE. The value of endoscopic ultrasonography in predicting resectability and margins of resection for periampullary tumors. Am Surg. 2008;74:1026–9.PubMed
33.
Lee JK, Kim AY, Kim PN, Lee MG, Ha HK. Prediction of vascular involvement and resectability by multidetector-row CT versus MR imaging with MR angiography in patients who underwent surgery for resection of pancreatic ductal adenocarcinoma. Eur J Radiol. 2010;73:310–6.PubMed
34.
Maithel SK, Maloney S, Winston C, et al. Preoperative CA 19-9 and the yield of staging laparoscopy in patients with radiographically resectable pancreatic adenocarcinoma. Ann Surg Oncol. 2008;15:3512–20.PubMed
35.
Seicean A, Badea R, Mocan T, et al. Radial endoscopic ultrasonography in the preoperative staging of pancreatic cancer. J Gastrointestin Liver Dis. 2008;17:273–8.PubMed
36.
Strobel K, Heinrich S, Bhure U, et al. Contrast-enhanced 18F-FDG PET/CT: 1-stop-shop imaging for assessing the resectability of pancreatic cancer. J Nucl Med. 2008;49:1408–13.PubMed
37.
Shah D, Fisher WE, Hodges SE, Wu MF, Hilsenbeck SG, Charles Brunicardi F. Preoperative prediction of complete resection in pancreatic cancer. J Surg Res. 2008;147:216–20.PubMed
38.
Manak E, Merkel S, Klein P, Papadopoulos T, Bautz WA, Baum U. Resectability of pancreatic adenocarcinoma: assessment using multidetector-row computed tomography with multiplanar reformations. Abdom Imaging. 2009;34:75–80.PubMed
39.
Park HS, Lee JM, Choi HK, Hong SH, Han JK, Choi BI. Preoperative evaluation of pancreatic cancer: comparison of gadolinium-enhanced dynamic MRI with MR cholangiopancreatography versus MDCT. J Magn Reson Imaging. 2009;30:586–95.PubMed
40.
Croome KP, Jayaraman S, Schlachta CM. Preoperative staging of cancer of the pancreatic head: is there room for improvement? Can J Surg. 2010;53:171–4.PubMedCentralPubMed
41.
Kaneko OF, Lee DM, Wong J, Kadell BM, Reber HA, Lu DS, Raman SS. Performance of multidetector computed tomographic angiography in determining surgical resectability of pancreatic head adenocarcinoma. J Comput Assist Tomogr. 2010;34:732–8.PubMed
42.
Aziz AM, Said T, Poovathumkadavil A, Almulla A. Using multidetector CT in predicting resectability of pancreatic head tumors: surgical and pathologic correlation. J Egypt Natl Canc Inst. 2010;22:233–9.PubMed
43.
Kent TS, Raptopoulos V, Callery MP, Gautam S, Vollmer CM. Escalating computed tomography angiogram (CTA) grade predicts unresectability and margin status for pancreaticobiliary neoplasms. HPB (Oxford). 2010;12:115–22.PubMedCentralPubMed
44.
Büchler MW, Friess H, Wagner M, Kulli C, Wagener V, Z’Graggen K. Pancreatic fistula after pancreatic head resection. Br J Surg. 2000;87:883–9.PubMed
45.
Balcom JH 4th, Rattner DW, Warshaw AL, Chang Y, Fernandez-del Castillo C. Ten-year experience with 733 pancreatic resections: changing indications, older patients, and decreasing length of hospitalization. Arch Surg. 2001;136:391–8.PubMed
46.
Richter A, Niedergethmann M, Sturm JW, Lorenz D, Post S, Trede M. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience. World J Surg. 2003;27:324–9.PubMed
47.
Schmidt CM, Powell ES, Yiannoutsos CT, et al. Pancreaticoduodenectomy: a 20-year experience in 516 patients. Arch Surg. 2004;139:718–25.PubMed
48.
Munoz-Bongrand N, Sauvanet A, Denys A, Sibert A, Vilgrain V, Belghiti J. Conservative management of pancreatic fistula after pancreaticoduodenectomy with pancreaticogastrostomy. J Am Coll Surg. 2004;199:198–203.PubMed
49.
Farnell MB, Pearson RK, Sarr MG, et al. A prospective randomized trial comparing standard pancreatoduodenectomy with pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head adenocarcinoma. Surgery. 2005;138:618–28.PubMed
50.
Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. Ann Surg. 2005;242:767–71.PubMedCentralPubMed
51.
Kazanjian KK, Hines OJ, Eibl G, Reber HA. Management of pancreatic fistulas after pancreaticoduodenectomy: results in 437 consecutive patients. Arch Surg. 2005;140:849–54.PubMed
52.
Winter JM, Cameron JL, Campbell KA, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience. J Gastrointest Surg. 2006;10:1199–210.PubMed
53.
DeOliveira ML, Winter JM, Schafer M, Cunningham SC, Cameron JL, Yeo CJ, Clavien PA. Assessment of complications after pancreatic surgery: a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 2006;244:931–7.PubMedCentralPubMed
54.
Aranha GV, Aaron JM, Shoup M, Pickleman J. Current management of pancreatic fistula after pancreaticoduodenectomy. Surgery. 2006;140:561–8.PubMed
55.
Carrère N, Sauvanet A, Goere D, et al. Pancreaticoduodenectomy with mesentericoportal vein resection for adenocarcinoma of the pancreatic head. World J Surg. 2006;30:1526–35.PubMed
56.
Grobmyer SR, Pieracci FM, Allen PJ, Brennan MF, Jaques DP. Defining morbidity after pancreaticoduodenectomy: use of a prospective complication grading system. J Am Coll Surg. 2007;204:356–64.PubMed
57.
Pratt WB, Maithel SK, Vanounou T, Huang ZS, Callery MP, Vollmer CM Jr. Clinical and economic validation of the International Study Group of Pancreatic Fistula (ISGPF) classification scheme. Ann Surg. 2007;245:443–51.PubMedCentralPubMed
58.
59.
Schnelldorfer T, Ware AL, Sarr MG, et al. Long-term survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible? Ann Surg. 2008;247:456–62.PubMed
60.
Veillette G, Dominguez I, Ferrone C, Thayer SP, McGrath D, Warshaw AL, Fernández-del Castillo C. Implications and management of pancreatic fistulas following pancreaticoduodenectomy: the Massachusetts General Hospital experience. Arch Surg. 2008;143:476–81.PubMedCentralPubMed
61.
Nikfarjam M, Sehmbey M, Kimchi ET, Gusani NJ, Shereef S, Avella DM, Staveley-O’Carroll KF. Additional organ resection combined with pancreaticoduodenectomy does not increase postoperative morbidity and mortality. J Gastrointest Surg. 2009;13:915–21.PubMed
62.
Haddad LB, Scatton O, Randone B, Andraus W, Massault PP, Dousset B, Soubrane O. Pancreatic fistula after pancreaticoduodenectomy: the conservative treatment of choice. HPB (Oxford). 2009;11:203–9.PubMedCentralPubMed
63.
Mukherjee S, Kocher HM, Hutchins RR, Bhattacharya S, Abraham AT. Impact of hospital volume on outcomes for pancreaticoduodenectomy: a single UK HPB centre experience. Eur J Surg Oncol. 2009;35:734–8.PubMed
64.
Busquets J, Fabregat J, Jorba R, et al. Surgical treatment of pancreatic adenocarcinoma by cephalic duodenopancreatectomy (part 1). Post-surgical complications in 204 cases in a reference hospital. Cir Esp. 2010;88:299–307.PubMed
65.
Bilimoria MM, Cormier JN, Mun Y, Lee JE, Evans DB, Pisters PW. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg. 2003;90:190–6.PubMed
66.
Balzano G, Zerbi A, Cristallo M, Di Carlo V. The unsolved problem of fistula after left pancreatectomy: the benefit of cautious drain management. J Gastrointest Surg. 2005;9:837–42.PubMed
67.
Pannegeon V, Pessaux P, Sauvanet A, Vullierme MP, Kianmanesh R, Belghiti J. Pancreatic fistula after distal pancreatectomy: predictive risk factors and value of conservative treatment. Arch Surg. 2006;141:1071–6.PubMed
68.
Sierzega M, Niekowal B, Kulig J, Popiela T. Nutritional status affects the rate of pancreatic fistula after distal pancreatectomy: a multivariate analysis of 132 patients. J Am Coll Surg. 2007;205:52–9.PubMed
69.
Kleeff J, Diener MK, Z’graggen K, et al. Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann Surg. 2007;245:573–82.PubMedCentralPubMed
70.
Ferrone CR, Warshaw AL, Rattner DW, et al. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg. 2008;12:1691–7.PubMedCentralPubMed
71.
Goh BK, Tan YM, Chung YF, et al. Critical appraisal of 232 consecutive distal pancreatectomies with emphasis on risk factors, outcome, and management of the postoperative pancreatic fistula: a 21-year experience at a single institution. Arch Surg. 2008;143:956–65.PubMed
72.
Kooby DA, Gillespie T, Bentrem D, et al. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg. 2008;248:438–46.PubMed
73.
Vin Y, Sima CS, Getrajdman GI, Brown KT, Covey A, Brennan MF, Allen PJ. Management and outcomes of postpancreatectomy fistula, leak, and abscess: results of 908 patients resected at a single institution between 2000 and 2005. J Am Coll Surg. 2008;207:490–8.PubMed
74.
Nathan H, Cameron JL, Goodwin CR, et al. Risk factors for pancreatic leak after distal pancreatectomy. Ann Surg. 2009;250:277–81.PubMed
75.
Meyer W, Jurowich C, Reichel M, Steinhäuser B, Wünsch PH, Gebhardt C. Pathomorphological and histological prognostic factors in curatively resected ductal adenocarcinoma of the pancreas. Surg Today. 2000;30:582–7.PubMed
76.
Yeo CJ, Cameron JL, Lillemoe KD, et al. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg. 2002;236:355–66.PubMedCentralPubMed
77.
Capussotti L, Massucco P, Ribero D, Viganò L, Muratore A, Calgaro M. Extended lymphadenectomy and vein resection for pancreatic head cancer: outcomes and implications for therapy. Arch Surg. 2003;138:1316–22.PubMed
78.
Berger AC, Watson JC, Ross EA, Hoffman JP. The metastatic/examined lymph node ratio is an important prognostic factor after pancreaticoduodenectomy for pancreatic adenocarcinoma. Am Surg. 2004;70:235–40.PubMed
79.
Sierzega M, Popiela T, Kulig J, Nowak K. The ratio of metastatic/resected lymph nodes is an independent prognostic factor in patients with node-positive pancreatic head cancer. Pancreas. 2006;33:240–5.PubMed
80.
Pawlik TM, Gleisner AL, Cameron JL, et al. Prognostic relevance of lymph node ratio following pancreaticoduodenectomy for pancreatic cancer. Surgery. 2007;141:610–8.PubMed
81.
Zacharias T, Jaeck D, Oussoultzoglou E, Neuville A, Bachellier P. Impact of lymph node involvement on long-term survival after R0 pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas. J Gastrointest Surg. 2007;11:350–6.PubMed
82.
House MG, Gönen M, Jarnagin WR, et al. Prognostic significance of pathologic nodal status in patients with resected pancreatic cancer. J Gastrointest Surg. 2007;11:1549–55.PubMed
83.
Smith RA, Bosonnet L, Ghaneh P, Raraty M, Sutton R, Campbell F, Neoptolemos JP. Preoperative CA19-9 levels and lymph node ratio are independent predictors of survival in patients with resected pancreatic ductal adenocarcinoma. Dig Surg. 2008;25:226–32.PubMed
84.
Riediger H, Keck T, Wellner U, zur Hausen A, Adam U, Hopt UT, Makowiec F. The lymph node ratio is the strongest prognostic factor after resection of pancreatic cancer. J Gastrointest Surg. 2009;13:1337–44.PubMed
85.
Hurtuk MG, Hughes C, Shoup M, Aranha GV. Does lymph node ratio impact survival in resected periampullary malignancies? Am J Surg. 2009;197:348–52.PubMed
86.
Murakami Y, Uemura K, Sudo T, et al. Number of metastatic lymph nodes, but not lymph node ratio, is an independent prognostic factor after resection of pancreatic carcinoma. J Am Coll Surg. 2010;211:196–204.PubMed
87.
Bhatti I, Peacock O, Awan AK, Semeraro D, Larvin M, Hall RI. Lymph node ratio versus number of affected lymph nodes as predictors of survival for resected pancreatic adenocarcinoma. World J Surg. 2010;34:768–75.PubMed
88.
Neoptolemos JP, Stocken DD, Dunn JA, et al. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001;234:758–68.PubMedCentralPubMed
89.
Ahmad NA, Lewis JD, Ginsberg GG, et al. Long term survival after pancreatic resection for pancreatic adenocarcinoma. Am J Gastroenterol. 2001;96:2609–15.PubMed
90.
Kuhlmann KF, de Castro SM, Wesseling JG, et al. Surgical treatment of pancreatic adenocarcinoma; actual survival and prognostic factors in 343 patients. Eur J Cancer. 2004;40:549–58.PubMed
91.
Howard TJ, Krug JE, Yu J, et al. A margin-negative R0 resection accomplished with minimal postoperative complications is the surgeon’s contribution to long-term survival in pancreatic cancer. J Gastrointest Surg. 2006;10:1338–45.PubMed
92.
Raut CP, Tseng JF, Sun CC, et al. Impact of resection status on pattern of failure and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Ann Surg. 2007;246:52–60.PubMedCentralPubMed
93.
Kato K, Yamada S, Sugimoto H, et al. Prognostic factors for survival after extended pancreatectomy for pancreatic head cancer: influence of resection margin status on survival. Pancreas. 2009;38:605–12.PubMed
94.
Campbell F, Smith RA, Whelan P, Sutton R, Raraty M, Neoptolemos JP, Ghaneh P. Classification of R1 resections for pancreatic cancer: the prognostic relevance of tumour involvement within 1 mm of a resection margin. Histopathology. 2009;55:277–83.PubMed
95.
Lavu H, Mascaro AA, Grenda DR, et al. Margin positive pancreaticoduodenectomy is superior to palliative bypass in locally advanced pancreatic ductal adenocarcinoma. J Gastrointest Surg. 2009;13:1937–46.PubMed
96.
Hatzaras I, George N, Muscarella P, Melvin WS, Ellison EC, Bloomston M. Predictors of survival in periampullary cancers following pancreaticoduodenectomy. Ann Surg Oncol. 2010;17:991–7.PubMedCentralPubMed
97.
Fatima J, Schnelldorfer T, Barton J, et al. Pancreatoduodenectomy for ductal adenocarcinoma: implications of positive margin on survival. Arch Surg. 2010;145:167–72.PubMed
98.
Jamieson NB, Foulis AK, Oien KA, et al. Positive mobilization margins alone do not influence survival following pancreatico-duodenectomy for pancreatic ductal adenocarcinoma. Ann Surg. 2010;251:1003–10.PubMed
99.
Wenger FA, Peter F, Zieren J, Steiert A, Jacobi CA, Müller JM. Prognosis factors in carcinoma of the head of the pancreas. Dig Surg. 2000;17:29–35.PubMed
100.
Kedra B, Popiela T, Sierzega M, Precht A. Prognostic factors of long-term survival after resective procedures for pancreatic cancer. Hepatogastroenterology. 2001;48:1762–6.PubMed
101.
Cleary SP, Gryfe R, Guindi M, et al. Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg. 2004;198:722–31.PubMed
102.
Wagner M, Redaelli C, Lietz M, Seiler CA, Friess H, Büchler MW. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg. 2004;91:586–94.PubMed
103.
Kure S, Kaneko T, Takeda S, Inoue S, Nakao A. Analysis of long-term survivors after surgical resection for invasive pancreatic cancer. HPB (Oxford). 2005;7:129–34.PubMedCentralPubMed
104.
Han SS, Jang JY, Kim SW, Kim WH, Lee KU, Park YH. Analysis of long-term survivors after surgical resection for pancreatic cancer. Pancreas. 2006;32:271–5.PubMed
105.
Ferrone CR, Brennan MF, Gonen M, et al. Pancreatic adenocarcinoma: the actual 5-year survivors. J Gastrointest Surg. 2008;12:701–6.PubMed
106.
Katz MH, Wang H, Fleming JB, et al. Long-term survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol. 2009;16:836–47.PubMedCentralPubMed
107.
Boggi U, Del Chiaro M, Croce C, et al. Prognostic implications of tumor invasion or adhesion to peripancreatic vessels in resected pancreatic cancer. Surgery. 2009;146:869–81.PubMed
108.
You DD, Lee HG, Heo JS, Choi SH, Choi DW. Prognostic factors and adjuvant chemoradiation therapy after pancreaticoduodenectomy for pancreatic adenocarcinoma. J Gastrointest Surg. 2009;13:1699–706.PubMed
109.
Fabregat J, Busquets J, Peláez N, et al. Surgical treatment of pancreatic adenocarcinoma using cephalic duodenopancreatectomy (part 2). Long term follow up after 204 cases. Cir Esp. 2010;88:374–82.PubMed
110.
Vollmer ChM, Pratt W, Vanounou T, Maithel SK, Callery MP. Quality assessment in high-acuity surgery. Volume and mortality are not enough. Arch Surg. 2007;142:371–80.PubMed
111.
Riall TS, Nealon WH, Goodwin JS, Townsend CM, Freeman JL. Outcomes following pancreatic resection: variability among high-volume providers. Surgery. 2008;144:133–40.PubMed
112.
Dimick JB, Welch HG, Birkmeyer JD. Surgical mortality as an indicator of hospital quality. The problem with small sample size. JAMA 2004;292:847–51.PubMed
113.
Bilimoria KY, Bentrem DJ, Lillemoe KD, Talamonti MS, Ko CY. Assessment of pancreatic cancer care in the United States based on formally developed quality indicators. J Natl Cancer Inst. 2009;101:848–59.PubMedCentralPubMed
114.
Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.PubMed
115.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMed
116.
Esposito I, Kleeff J, Bergmann F, et al. Most pancreatic cancer resections are R1 resections. Ann Surg Oncol. 2008;15:1651–60.PubMed
117.
Gutierrez JC, Franceschi D, Koniaris LG. How many lymph nodes properly stage a periampullary malignancy? J Gastrointest Surg. 2008;12:77–85.PubMed
118.
Garcea G, Dennison AR, Pattenden CJ, Neal CP, Sutton CD, Berry DP. Survival following curative resection for pancreatic ductal adenocarcinoma. A systematic review of the literature. JOP. 2008;9:99–132.PubMed
Metadaten
Titel
Outcome Quality Standards in Pancreatic Oncologic Surgery
verfasst von
Luis Sabater, PhD
Alvaro García-Granero, MD
Javier Escrig-Sos, PhD
Maria del Carmen Gómez-Mateo, MD
Juan Sastre, PhD
Antonio Ferrández, PhD
Joaquín Ortega, PhD
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2014
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3451-2

Weitere Artikel der Ausgabe 4/2014

Annals of Surgical Oncology 4/2014 Zur Ausgabe

Gastrointestinal Oncology

The Promise of Modern Radiotherapy in Resected Pancreatic Adenocarcinoma: A Response to Bekaii-Saab et al.

Hepatobiliary Tumors

Establishment of a Multidisciplinary Hepatocellular Carcinoma Clinic is Associated with Improved Clinical Outcome

Gastrointestinal Oncology

A Body Shape Index Has a Good Correlation with Postoperative Complications in Gastric Cancer Surgery

Gastrointestinal Oncology

Is Atypical Metastasis Obstructive to Sentinel Node Navigation Surgery in Early Gastric Cancer Patients?

Healthcare Policy and Outcomes

National Assessment of Margin Status as a Quality Indicator after Pancreatic Cancer Surgery

Endocrine Tumors

Parathyroid Surgery in the Elderly: Should Minimally Invasive Surgery Be Abandoned?

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.
Bildnachweise