Predictors of long-term survival after pancreaticoduodenectomy for peri-ampullary adenocarcinoma: A retrospective study of 5-year survivors.
Hepatobiliary Pancreat Dis Int
; 17(5): 443-449, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-30126828
ABSTRACT
BACKGROUND:
Pancreaticoduodenectomy (PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival (≥â¯5 years) after PD.METHODS:
This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups group (I) patients who survived less than 5 years and group (II) patients who survivedâ¯≥â¯5 years.RESULTS:
There were 47 (20.6%) long-term survivors (≥â¯5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31 (66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include ageâ¯<â¯60 years old, serum CEAâ¯<â¯5â¯ng/mL, serum CA 19-9â¯<â¯37â¯U/mL, non-cirrhotic liver, tumor sizeâ¯<â¯2â¯cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9â¯<â¯37â¯U/mL [OR (95% CI)â¯=â¯1.712 (1.248-2.348), Pâ¯=â¯0.001], smaller tumor size [OR (95% CIâ¯)=â¯1.335 (1.032-1.726), Pâ¯=â¯0.028] and Ro resection [OR (95% CI)â¯=â¯3.098 (2.095-4.582), Pâ¯<â¯0.001] were independent factors for survivalâ¯≥â¯5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%.CONCLUSIONS:
The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9â¯<â¯37â¯U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survivalâ¯≥â¯5 years.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
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Ampola Hepatopancreática
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Adenocarcinoma
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Pancreaticoduodenectomia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article