PMID- 19707831
OWN - NLM
STAT- MEDLINE
DCOM- 20100415
LR  - 20100126
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 16
IP  - 12
DP  - 2009 Dec
TI  - Resectable pancreatic cancer: who really benefits from resection?
PG  - 3316-22
LID - 10.1245/s10434-009-0670-7 [doi]
AB  - 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.
FAU - Barugola, Giuliano
AU  - Barugola G
AD  - Chirurgia Generale B, Department of Surgery, University of Verona, Verona, Italy.
FAU - Partelli, Stefano
AU  - Partelli S
FAU - Marcucci, Stefano
AU  - Marcucci S
FAU - Sartori, Nora
AU  - Sartori N
FAU - Capelli, Paola
AU  - Capelli P
FAU - Bassi, Claudio
AU  - Bassi C
FAU - Pederzoli, Paolo
AU  - Pederzoli P
FAU - Falconi, Massimo
AU  - Falconi M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Aged
MH  - Carcinoma, Pancreatic Ductal/pathology/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/pathology/*surgery
MH  - Neoplasm Staging
MH  - *Pancreatectomy
MH  - Pancreatic Neoplasms/pathology/*surgery
MH  - Perioperative Care
MH  - Prognosis
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2009/08/27 09:00
MHDA- 2010/04/16 06:00
CRDT- 2009/08/27 09:00
PHST- 2009/01/19 00:00 [received]
PHST- 2009/08/27 09:00 [entrez]
PHST- 2009/08/27 09:00 [pubmed]
PHST- 2010/04/16 06:00 [medline]
AID - 10.1245/s10434-009-0670-7 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2009 Dec;16(12):3316-22. doi: 10.1245/s10434-009-0670-7.