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Peri‐operative mortality and long‐term survival after total pancreatectomy for pancreatic adenocarcinoma: A population‐based perspective
Author(s) -
Nathan Hari,
Wolfgang Christopher L.,
Edil Barish H.,
Choti Michael A.,
Herman Joseph M.,
Schulick Richard D.,
Cameron John L.,
Pawlik Timothy M.
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21189
Subject(s) - medicine , pancreaticoduodenectomy , adenocarcinoma , hazard ratio , pancreatectomy , gastroenterology , pancreatic cancer , population , pancreatic head , pancreas , surgery , cancer , confidence interval , environmental health
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. J. Surg. Oncol. 2009;99: 87–92. © 2008 Wiley‐Liss, Inc.