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Risk‐stratified analysis of pasireotide for patients undergoing pancreatectomy
Author(s) -
Peng June S.,
Joyce Daniel,
Brady Maureen,
Groman Adrienne,
Attwood Kristopher,
Kuvshinoff Boris,
Hochwald Steven N.,
Kukar Moshim
Publication year - 2020
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.25949
Subject(s) - medicine , pasireotide , pancreatic fistula , pancreaticoduodenectomy , pancreatectomy , gastroenterology , retrospective cohort study , distal pancreatectomy , surgery , resection , acromegaly , pancreas , growth hormone , hormone
Background and Objectives Pasireotide was shown in a randomized trial to decrease the rate of postoperative pancreatic fistula (POPF). However, retrospective series from other centers have failed to confirm these results. Methods Patients who underwent pancreatoduodenectomy or distal pancreatectomy between January 2014 and February 2019 were included. Patients treated after November 2016 routinely received pasireotide and were compared to a retrospective cohort. Multivariate analysis was performed for the outcome of clinically relevant POPF (CR‐POPF), with stratification by fistula risk score (FRS). Results Ninety‐nine of 300 patients received pasireotide. The distribution of high, intermediate, low, and negligible risk patients by FRS was comparable ( P = .487). There were similar rates of CR‐POPF (19.2% pasireotide vs 14.9% control, P = .347) and percutaneous drainage (12.1% vs 10.0%, P = .567), with greater median number of drain days in the pasireotide group (6 vs 4 days, P < .001). Multivariate modeling for CR‐POPF showed no correlation with operation or pasireotide use. Adjustment with propensity weighted models for high (OR, 1.02, 95% CI, 0.45‐2.29) and intermediate (OR, 1.02, CI, 0.57‐1.81) risk groups showed no correlation of pasireotide with reduction in CR‐POPF. Conclusions Pasireotide administration after pancreatectomy was not associated with a decrease in CR‐POPF, even when patients were stratified by FRS.