Surgical results of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: A multi-institutional retrospective study of 174 patients

Yo Ichi Yamashita, Tomoharu Yoshizumi, Kengo Fukuzawa, Takashi Nishizaki, Eiji Tsujita, Kiyoshi Kajiyama, Yuji Soejima, Motoyuki Yamagata, Kazuharu Yamamoto, Eisuke Adachi, Keishi Sugimachi, Yasuharu Ikeda, Hideaki Uchiyama, Takashi Maeda, Shinji Itoh, Norifumi Harimoto, Toru Ikegami, Yoshihiko Maehara

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Abstract

Background: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduo-denectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. Patients and Methods: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified. Results: POPF occured in 26 patients (15%), and 18 patients (10%) were diagnosed as Grade B/C POPF. The independent risk factors for Grade B/C POPF were body mass index (BMI) ≥25 (Odds Ratio [OR]=21.1, p=0.006) and absence of post-operative enteral nutrition (EN) (OR=10.2, p=0.04). The 1-, 3-, and 5-year overall survivals of patients with PDAC after PD were 76%, 35%, and 18%, respectively. R1/2 operation was identified as the only independent poor prognostic factor (Hazard Ratio=3.66; p=0.0002). Conclusion: Patients with BMI ≥25 should be closely monitored for POPF after PD. Post-operative EN might help prevent POPF. Performing R0 resection is an important goal for ensuring patient survival after PD for PDAC.

Original languageEnglish
Pages (from-to)2407-2412
Number of pages6
JournalAnticancer research
Volume36
Issue number5
Publication statusPublished - Jan 1 2016

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Pancreaticoduodenectomy
Pancreatic Fistula
Adenocarcinoma
Retrospective Studies
Enteral Nutrition
Body Mass Index
Odds Ratio
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Yamashita, Y. I., Yoshizumi, T., Fukuzawa, K., Nishizaki, T., Tsujita, E., Kajiyama, K., ... Maehara, Y. (2016). Surgical results of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: A multi-institutional retrospective study of 174 patients. Anticancer research, 36(5), 2407-2412.

Surgical results of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma : A multi-institutional retrospective study of 174 patients. / Yamashita, Yo Ichi; Yoshizumi, Tomoharu; Fukuzawa, Kengo; Nishizaki, Takashi; Tsujita, Eiji; Kajiyama, Kiyoshi; Soejima, Yuji; Yamagata, Motoyuki; Yamamoto, Kazuharu; Adachi, Eisuke; Sugimachi, Keishi; Ikeda, Yasuharu; Uchiyama, Hideaki; Maeda, Takashi; Itoh, Shinji; Harimoto, Norifumi; Ikegami, Toru; Maehara, Yoshihiko.

In: Anticancer research, Vol. 36, No. 5, 01.01.2016, p. 2407-2412.

Research output: Contribution to journalArticle

Yamashita, YI, Yoshizumi, T, Fukuzawa, K, Nishizaki, T, Tsujita, E, Kajiyama, K, Soejima, Y, Yamagata, M, Yamamoto, K, Adachi, E, Sugimachi, K, Ikeda, Y, Uchiyama, H, Maeda, T, Itoh, S, Harimoto, N, Ikegami, T & Maehara, Y 2016, 'Surgical results of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: A multi-institutional retrospective study of 174 patients', Anticancer research, vol. 36, no. 5, pp. 2407-2412.
Yamashita, Yo Ichi ; Yoshizumi, Tomoharu ; Fukuzawa, Kengo ; Nishizaki, Takashi ; Tsujita, Eiji ; Kajiyama, Kiyoshi ; Soejima, Yuji ; Yamagata, Motoyuki ; Yamamoto, Kazuharu ; Adachi, Eisuke ; Sugimachi, Keishi ; Ikeda, Yasuharu ; Uchiyama, Hideaki ; Maeda, Takashi ; Itoh, Shinji ; Harimoto, Norifumi ; Ikegami, Toru ; Maehara, Yoshihiko. / Surgical results of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma : A multi-institutional retrospective study of 174 patients. In: Anticancer research. 2016 ; Vol. 36, No. 5. pp. 2407-2412.
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abstract = "Background: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduo-denectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. Patients and Methods: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified. Results: POPF occured in 26 patients (15{\%}), and 18 patients (10{\%}) were diagnosed as Grade B/C POPF. The independent risk factors for Grade B/C POPF were body mass index (BMI) ≥25 (Odds Ratio [OR]=21.1, p=0.006) and absence of post-operative enteral nutrition (EN) (OR=10.2, p=0.04). The 1-, 3-, and 5-year overall survivals of patients with PDAC after PD were 76{\%}, 35{\%}, and 18{\%}, respectively. R1/2 operation was identified as the only independent poor prognostic factor (Hazard Ratio=3.66; p=0.0002). Conclusion: Patients with BMI ≥25 should be closely monitored for POPF after PD. Post-operative EN might help prevent POPF. Performing R0 resection is an important goal for ensuring patient survival after PD for PDAC.",
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T2 - A multi-institutional retrospective study of 174 patients

AU - Yamashita, Yo Ichi

AU - Yoshizumi, Tomoharu

AU - Fukuzawa, Kengo

AU - Nishizaki, Takashi

AU - Tsujita, Eiji

AU - Kajiyama, Kiyoshi

AU - Soejima, Yuji

AU - Yamagata, Motoyuki

AU - Yamamoto, Kazuharu

AU - Adachi, Eisuke

AU - Sugimachi, Keishi

AU - Ikeda, Yasuharu

AU - Uchiyama, Hideaki

AU - Maeda, Takashi

AU - Itoh, Shinji

AU - Harimoto, Norifumi

AU - Ikegami, Toru

AU - Maehara, Yoshihiko

PY - 2016/1/1

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N2 - Background: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduo-denectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. Patients and Methods: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified. Results: POPF occured in 26 patients (15%), and 18 patients (10%) were diagnosed as Grade B/C POPF. The independent risk factors for Grade B/C POPF were body mass index (BMI) ≥25 (Odds Ratio [OR]=21.1, p=0.006) and absence of post-operative enteral nutrition (EN) (OR=10.2, p=0.04). The 1-, 3-, and 5-year overall survivals of patients with PDAC after PD were 76%, 35%, and 18%, respectively. R1/2 operation was identified as the only independent poor prognostic factor (Hazard Ratio=3.66; p=0.0002). Conclusion: Patients with BMI ≥25 should be closely monitored for POPF after PD. Post-operative EN might help prevent POPF. Performing R0 resection is an important goal for ensuring patient survival after PD for PDAC.

AB - Background: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduo-denectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. Patients and Methods: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified. Results: POPF occured in 26 patients (15%), and 18 patients (10%) were diagnosed as Grade B/C POPF. The independent risk factors for Grade B/C POPF were body mass index (BMI) ≥25 (Odds Ratio [OR]=21.1, p=0.006) and absence of post-operative enteral nutrition (EN) (OR=10.2, p=0.04). The 1-, 3-, and 5-year overall survivals of patients with PDAC after PD were 76%, 35%, and 18%, respectively. R1/2 operation was identified as the only independent poor prognostic factor (Hazard Ratio=3.66; p=0.0002). Conclusion: Patients with BMI ≥25 should be closely monitored for POPF after PD. Post-operative EN might help prevent POPF. Performing R0 resection is an important goal for ensuring patient survival after PD for PDAC.

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