Determination of factors predictive of outcome for patients undergoing a pancreaticoduodenectomy of pancreatic head ductal adenocarcinomas
Article first published online: 2 MAR 2012
© 2012 International Hepato-Pancreato-Biliary Association
Volume 14, Issue 5, pages 310–316, May 2012
How to Cite
Eeson, G., Chang, N., McGahan, C. E., Khurshed, F., Buczkowski, A. K., Scudamore, C. H., Warnock, G. L. and Chung, S. W. (2012), Determination of factors predictive of outcome for patients undergoing a pancreaticoduodenectomy of pancreatic head ductal adenocarcinomas. HPB, 14: 310–316. doi: 10.1111/j.1477-2574.2012.00448.x
- Issue published online: 4 APR 2012
- Article first published online: 2 MAR 2012
- Received 22 September 2011; accepted 24 January 2012
- pancreatic neoplasia;
- resection < pancreatic neoplasia;
- Whipple resection
Introduction: A pancreaticoduodenectomy is the reference treatment for a resectable pancreatic head ductal adenocarcinoma. The probability of 5-year survival in patients undergoing such treatment is 5–25% and is associated with relatively high peri-operative morbidity and mortality. The objective of the present study was to evaluate risk factors predictive of outcome for patients undergoing a pancreaticoduodenectomy for a pancreatic adenocarcinoma.
Methods: This retrospective analysis incorporated data from the Vancouver General Hospital and the British Columbia Cancer Agency (BCCA) from 1999–2007.
Results: The 5-year survival of 100 patients was 12% with a median survival of 16.5 months. Ninety-day mortality was 7%. Predictors of 90-day mortality included age ≥ 80 years (P < 0.001) and an American Society of Anesthesiologists (ASA) score = 3 (P= 0.012) by univariate analysis and age ≥80 years (P < 0.001) by multivariate analysis. The identifiable predictive factor for poor 5-year survival was an ASA score = 3 (P= 0.043) whereas a Dindo–Clavien surgical complication grade ≥ 3 was associated with a worse outcome (P= 0.013). Referral to the BCCA was associated with a favourable 5-year survival (P= 0.001).
Conclusions: The present study identifies risk factors for patient selection to enhance survival benefit in this patient population.