The Library
Influence of surgical resection and post-operative complications on survival following adjuvant treatment for pancreatic cancer in the ESPAC-1 randomized controlled trial
Tools
Tools
Tools
Bassi, C., Stocken, D. D., Olah, A., Friess, H., Buckels, J., Hickey, H., Dervenis, C., Dunn, Janet A., Deakin, M., Carter, R., Ghaneh, P., Neoptolemos, J. P. and Büchler, M. W. (2005) Influence of surgical resection and post-operative complications on survival following adjuvant treatment for pancreatic cancer in the ESPAC-1 randomized controlled trial. Digestive Surgery, 22 (5). pp. 353-363. doi:10.1159/000089771
Research output not available from this repository, contact author.
Official URL: https://doi.org/10.1159/000089771
Abstract
Background/Aims: The influence of type of surgery and occurrence of post-operative complications on survival following adjuvant therapy for pancreatic cancer are uncertain. Methods: Cox proportional hazard modelling was used to investigate the influence of type of surgery and the presence of complications on survival in conjunction with clinico-pathological variables in the 550 patients of the ESPAC-1 adjuvant randomized controlled trial. Results: Standard Kausch-Whipple (KW) was performed in 282 (54%) patients, 186 (35%) had a pylorus-preserving (PP) KW, 39 (7%) had a distal pancreatectomy and 21 (4%) had a total pancreatectomy. Post-operative complications were reported in 140 (27%) patients. PP-KW patients survived longer with a median (95% CI) survival of 19.9 (17.3, 23.1) months compared to 14.8 (13.0, 16.7) for KW patients (χ 2 LR = 15.1, p < 0.001). KW patients were more likely however to have R1 margins (67 (24%) vs. 29 (16%), χ 2 = 4.59, p = 0.032), poorly differentiated tumours (70 (26%) vs. 19 (10%), χ 2 = 18.65, p < 0.001) and positive lymph nodes (165 (60%) vs. 81 (44%), χ 2 = 11.32, p < 0.001). Post-operative complications did not significantly affect survival. Independent prognostic factors were tumour grade, nodal status and tumour size but not type of surgery or post-operative complications. There was a survival benefit for chemotherapy irrespective of the type of surgery or post-operative complications. Conclusions: The KW and PP-KW procedures did not significantly influence the hazard of death in the presence of tumour staging, demonstrating that ESPAC-1 surgeons showed good judgement in their choice of operation. Post-operative complications did not adversely affect the survival benefit from adjuvant chemotherapy. Copyright © 2005 S. Karger AG.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
||||||
| Journal or Publication Title: | Digestive Surgery | ||||||
| Publisher: | S. Karger AG | ||||||
| ISSN: | 0253-4886 | ||||||
| Official Date: | 2005 | ||||||
| Dates: |
|
||||||
| Volume: | 22 | ||||||
| Number: | 5 | ||||||
| Page Range: | pp. 353-363 | ||||||
| DOI: | 10.1159/000089771 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
