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Surgical exploration without resection in pancreatic and periampullary tumors : report from a national database

Sahlström, E. LU ; Nilsson, J. LU ; Tingstedt, B. LU ; Bergenfeldt, M. LU ; Andersson, R. LU and Andersson, B. LU (2020) In Scandinavian Journal of Surgery
Abstract

Background and Aims: Pancreatic and periampullary cancers are sometimes found to have a too advanced disease during surgery to allow resection. The aim was to describe characteristics, treatment, outcome, and time trends for patients that were planned for pancreatic surgery but found unresectable during surgery. Material and Methods: Data from the Swedish National Pancreatic and Periampullary Cancer Registry were used. All patients registered between January 2010 and August 2018 were included. The patient cohort was divided in two halves based on year of diagnosis. Results: In total, 12,377 patients were included in the registry and finally 4568 patients were scheduled for surgery. During surgical exploration, 3879 (84.9%) patients... (More)

Background and Aims: Pancreatic and periampullary cancers are sometimes found to have a too advanced disease during surgery to allow resection. The aim was to describe characteristics, treatment, outcome, and time trends for patients that were planned for pancreatic surgery but found unresectable during surgery. Material and Methods: Data from the Swedish National Pancreatic and Periampullary Cancer Registry were used. All patients registered between January 2010 and August 2018 were included. The patient cohort was divided in two halves based on year of diagnosis. Results: In total, 12,377 patients were included in the registry and finally 4568 patients were scheduled for surgery. During surgical exploration, 3879 (84.9%) patients underwent pancreatic resection, 658 (14.4%) patients were found unresectable, and 31 (0.7%) had no pancreatic resection due to other reasons (e.g. benign lesion, comorbidity). More patients underwent surgical exploration and resection during the second time period, but exploration without resection was unchanged (15.7% vs 13.7%; p = 0.062). Survival rates were lower among the unresectable patients with pancreatic and periampullary tumors compared to the resectable patients, including 30-day mortality (n = 17 (3.5%) vs n = 39 (1.6%), p = 0.004) and 90-day mortality (n = 72 (15.0%) vs n = 70 (2.8%), p < 0.001). Palliative surgery became less common during the second half of the time period (p < 0.001). Conclusion: Unresectability is associated with an unfavorable prognosis. The frequency did not decrease during the study period, but palliative surgical procedures became less common.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
palliative surgery, Pancreatic cancer, pancreatic resection, periampullary cancer, survival, unresectability
in
Scandinavian Journal of Surgery
publisher
Finnish Surgical Society
external identifiers
  • scopus:85083511689
ISSN
1457-4969
DOI
10.1177/1457496920913669
language
English
LU publication?
yes
id
0a7d0129-8b9e-46f3-8c77-5d0e6521c946
date added to LUP
2020-04-30 15:32:57
date last changed
2020-05-06 06:29:04
@article{0a7d0129-8b9e-46f3-8c77-5d0e6521c946,
  abstract     = {<p>Background and Aims: Pancreatic and periampullary cancers are sometimes found to have a too advanced disease during surgery to allow resection. The aim was to describe characteristics, treatment, outcome, and time trends for patients that were planned for pancreatic surgery but found unresectable during surgery. Material and Methods: Data from the Swedish National Pancreatic and Periampullary Cancer Registry were used. All patients registered between January 2010 and August 2018 were included. The patient cohort was divided in two halves based on year of diagnosis. Results: In total, 12,377 patients were included in the registry and finally 4568 patients were scheduled for surgery. During surgical exploration, 3879 (84.9%) patients underwent pancreatic resection, 658 (14.4%) patients were found unresectable, and 31 (0.7%) had no pancreatic resection due to other reasons (e.g. benign lesion, comorbidity). More patients underwent surgical exploration and resection during the second time period, but exploration without resection was unchanged (15.7% vs 13.7%; p = 0.062). Survival rates were lower among the unresectable patients with pancreatic and periampullary tumors compared to the resectable patients, including 30-day mortality (n = 17 (3.5%) vs n = 39 (1.6%), p = 0.004) and 90-day mortality (n = 72 (15.0%) vs n = 70 (2.8%), p &lt; 0.001). Palliative surgery became less common during the second half of the time period (p &lt; 0.001). Conclusion: Unresectability is associated with an unfavorable prognosis. The frequency did not decrease during the study period, but palliative surgical procedures became less common.</p>},
  author       = {Sahlström, E. and Nilsson, J. and Tingstedt, B. and Bergenfeldt, M. and Andersson, R. and Andersson, B.},
  issn         = {1457-4969},
  language     = {eng},
  month        = {04},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {Surgical exploration without resection in pancreatic and periampullary tumors : report from a national database},
  url          = {http://dx.doi.org/10.1177/1457496920913669},
  doi          = {10.1177/1457496920913669},
  year         = {2020},
}