title: The effect of wait times on oncological outcomes from periampullary adenocarcinomas.
abstract: BACKGROUND
  Overall few patients presenting with periampullary adenocarcinomas have resectable lesions. We postulated that rapid diagnosis and treatment would enhance the likelihood of successful resection, improving survival.
  
  
  METHODS
  A retrospective analysis of patients undergoing surgery for resection of a pancreatic or periampullary lesion was conducted. Resection rate, disease stage and survival were evaluated as a function of wait times.
  
  
  RESULTS
  Pancreatic resections were booked in 355 patients. Of 193 patients with periampullary adenocarcinomas, 119 patients (61.7%) had resectable disease. There was no difference in median time from initial physician consultation to surgery in patients with resectable and unresectable disease (61 days vs. 64 days, respectively). The likelihood of successful resection was virtually identical in patients with wait times ≤ 30 and > 30 days (from surgical consultation to procedure). There was a trend toward a higher T-stage in patients who waited >30 days for surgery (P = 0.055). However, there was no difference in survival as a function of wait time.
  
  
  CONCLUSIONS
  This series does not demonstrate an advantage for rapid diagnosis and surgery, in terms of resection rate and survival. However, further study is required in a larger cohort of patients, to confirm these findings.
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Spencer R
authors.initials: SR
authors.lastname: McLean
authors.forename: Divya
authors.initials: D
authors.lastname: Karsanji
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wilson
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.forename: Francis R
authors.initials: FR
authors.lastname: Sutherland
authors.forename: Janice
authors.initials: J
authors.lastname: Pasieka
authors.forename: Chad
authors.initials: C
authors.lastname: Ball
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Bathe
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D002170:Canada; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists