Peri-operative mortality and long-term survival after total pancreatectomy for pancreatic adenocarcinoma: A population-based perspective

Hari Nathan, Christopher L. Wolfgang, Barish H. Edil, Michael A. Choti, Joseph M. Herman, Richard D. Schulick, John L. Cameron, Timothy M. Pawlik

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Background and Objectives: Many surgeons perceive total pancreatectomy (TP) for pancreatic adenocarcinoma to be associated with inferior outcomes compared to partial pancreatectomy (PP), such as pancreaticoduodenectomy (PD) and distal pancreatectomy (DP). We sought to analyze peri-operative mortality and long-term survival following TP versus PP for pancreatic adenocarcinoma. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with resected pancreatic adenocarcinoma (1998-2004). Survival after TP versus PP was compared by tumor location. Results: Of 3280 patients with resected pancreatic head tumors, 292 underwent TP, and 2988 PD. One-month mortality was 9.0% for TP and 6.5% for PD (P = 0.11). Of 315 patients with resected body/tail tumors, 32 underwent TP, and 283 DP. One-month mortality was 9.3% for TP and 3.9% for DP (P = 0.17). Of 426 patients with resected tumors in unspecified pancreatic locations, 52 underwent TP, and 374 PP. One-month mortality was 5.8% for TP and 6.5% for PP (P = 0.87). Survival analyses demonstrated no difference between TP and PP (hazard ratio (HR) 1.06, P = 0.49 for head; HR 0.84, P = 0.51 for body/tail; HR 1.06, P = 0.79 for unspecified locations). Conclusions: Peri-operative mortality and long-term survival are similar following TP versus PP for pancreatic adenocarcinoma, supporting the use of TP when oncologically appropriate.

Original languageEnglish (US)
Pages (from-to)87-92
Number of pages6
JournalJournal of Surgical Oncology
Volume99
Issue number2
DOIs
StatePublished - Feb 1 2009

Keywords

  • Outcomes
  • Pancreatic adenocarcinoma
  • SEER
  • Survival
  • Total pancreatectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Nathan, H., Wolfgang, C. L., Edil, B. H., Choti, M. A., Herman, J. M., Schulick, R. D., Cameron, J. L., & Pawlik, T. M. (2009). Peri-operative mortality and long-term survival after total pancreatectomy for pancreatic adenocarcinoma: A population-based perspective. Journal of Surgical Oncology, 99(2), 87-92. https://doi.org/10.1002/jso.21189