title: Postoperative complications deteriorate long-term outcome in pancreatic cancer patients.
abstract: BACKGROUND
  Different tumor-specific prognostic factors have been identified in recent years for patients who undergo surgery due to pancreatic head cancer, but the results often were inconsistent. Furthermore, the impact of postoperative complications on patient long-term survival has not been described.
  
  
  METHODS
  The long-term outcome of 428 patients who underwent resection of pancreatic head cancer at our center during a 17-year period was evaluated. Perioperative details, including postoperative complications, as well as the follow-up of all patients who left the hospital postoperatively were collected in a prospective database. Univariate and multivariate models were used to identify potential prognostic factors and to evaluate the impact of postoperative complications on long-term survival.
  
  
  RESULTS
  The median survival was 15.5 months with a postoperative complication rate (grade I-IV) of 32.7%. Independent prognostic significance was detected for grading (P < 0.001), R status (P = 0.001), and lymph node status (P = 0.003). The occurrence of severe postoperative complications (grade III-IV) was associated with a significantly shortened survival (16.5 vs. 12.4 months; P = 0.002) and was identified as an independent prognostic factor (P = 0.002).
  
  
  CONCLUSIONS
  This large study demonstrates that severe postoperative complications have a strong impact on the long-term survival of patients with pancreatic head cancer comparable to tumor characteristics, such as lymph node status, grading, or R status. As a result, the improvement of surgical procedures in specialized centers might lead to a survival benefit in these patients.
authors: Department of General, Visceral and Transplantation Surgery, Charité, University Medicine, Berlin, Germany. carsten.kamphues@charite.de
authors: Carsten
authors: C
authors: Kamphues
authors: Roberta
authors: R
authors: Bova
authors: Dorothee
authors: D
authors: Schricke
authors: Michael
authors: M
authors: Hippler-Benscheidt
authors: Frederick
authors: F
authors: Klauschen
authors: Albrecht
authors: A
authors: Stenzinger
authors: Daniel
authors: D
authors: Seehofer
authors: Matthias
authors: M
authors: Glanemann
authors: Peter
authors: P
authors: Neuhaus
authors: Marcus
authors: M
authors: Bahra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult