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Resectable Pancreatic Cancer: Who Really Benefits From Resection?

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The 1-year disease-related mortality after resection for pancreatic cancer is approximately 30%. This study examined potential preoperative parameters that would help avoid unnecessary surgery.

Methods

Among the patients resected at our institution from 1997 to 2006, a total of 228 underwent pancreatic resection for ductal adenocarcinoma. By means of a survival cutoff of 12 months, two groups were created: early death (ED) and long survivors. A logistic regression analysis was performed to identify perioperative predictors of ED.

Results

Among 228 resected patients, postoperative mortality occurred in four cases (1.8%) that were excluded from the study. In the remaining 224 patients, 43 (19.2%) died of disease within 12 months from surgery (ED), and the remaining 181 (80.8%) had a longer survival. Multivariate analysis selected duration of preoperative symptoms >40 days, CA 19-9 > 200 U/mL, pathological grading G3–G4, and R2 resection as independent predictors of ED.

Conclusions

Duration of symptoms, CA 19-9 serum level, and pathological grading possibly retrieved by endoscopic ultrasound–guided biopsy can be preoperatively used to identify patients with disease that is not suitable for up-front surgery, even if deemed resectable by high-quality imaging.

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Authors and Affiliations

  1. Chirurgia Generale B, Department of Surgery, University of Verona, Verona, Italy

    Giuliano Barugola MD, Stefano Partelli MD, Stefano Marcucci MD, Nora Sartori MD, Claudio Bassi MD, Paolo Pederzoli MD & Massimo Falconi MD

  2. Department of Pathology, University of Verona, Verona, Italy

    Paola Capelli MD

Authors
  1. Giuliano Barugola MD
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  2. Stefano Partelli MD
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  3. Stefano Marcucci MD
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  4. Nora Sartori MD
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  5. Paola Capelli MD
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  6. Claudio Bassi MD
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  7. Paolo Pederzoli MD
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  8. Massimo Falconi MD
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Corresponding author

Correspondence to Massimo Falconi MD.

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Barugola, G., Partelli, S., Marcucci, S. et al. Resectable Pancreatic Cancer: Who Really Benefits From Resection?. Ann Surg Oncol 16, 3316–3322 (2009). https://doi.org/10.1245/s10434-009-0670-7

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  • DOI: https://doi.org/10.1245/s10434-009-0670-7

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