Improvement of surgical and survival outcomes of patients with pancreatic cancer who underwent pancreaticoduodenectomy: a Chinese experience.
OBJECTIVE
To analyze our experience and the surgical and survival outcomes of patients with pancreatic carcinoma who underwent pancreaticoduodenectomy (PD) by analysis of a retrospective cohort of 205 patients over a 10 years period.


METHODS
The patients were categorized into two 5-year periods: period 1, from 2000 January 1 to 2004 December 31(group 1, n = 48) and period 2, from 2005 January 1 to 2009 December 31(group 2, n = 157). We analysis the data using statistical software and find the improvement of surgical and survival outcomes of PD for pancreatic cancer in the past 10 years.


RESULTS
The two groups have similar age, sex distribution, comorbidity, preoperative serum tumor markers, patients number of preoperative biliary drainage and postoperative chemotherapy. More patients in group 2 underwent lymph nodes dissection (P = 0.031). And patients of group 2 had a better surgical outcomes and longer 5-year overall survival (8% vs. 19%, P = 0.036). The blood loss volume, transfusion volume, and the number of patients need blood transfusion were significantly fewer (P < 0.001) for the patients in group 2, however, the operation time was obviously lengthened (P = 0.002). Patients in Group 1 suffered more postoperative complications than those of the patients in group 2 (P = 0.021). A significant difference was reached for survival between the two group (P = 0.036).


CONCLUSIONS
A significant improvement of surgical and survival outcomes after PD for pancreatic cancer patients was achieved in the past 10 years. PD remains the only treatment option that potentially provides a cure for pancreatic head cancer, and postoperative chemotherapy may produce survival benefit.
Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Huan-Hu-Xi Road, He Xi District, Tianjin 300060, PR China.
Chang Ming
CM
Shen
Guang Cai
GC
Niu
Wei
W
Cui
Qiang
Q
Li
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome