title: Long-term survival after resections for pancreatic ductal adenocarcinoma. Single centre study.
abstract: OBJECTIVE
  To analyse the 5-year survival rate of patients undergoing radical surgery for pancreatic ductal adenocarcinoma (PDAC) and to identify prognostic factors.
  
  
  METHODS
  A prospectively maintained database of 90 consecutive patients who underwent radical resection for PDAC was analysed. Survival was evaluated using the Kaplan-Meier method. Log-rank test and Cox regression analysis were used for the evaluation of prognostic factors. P values less than 0.05 were considered significant.
  
  
  RESULTS
  Mean age (± standard deviation) was 63.2±8.6 years (female 28.9% and male 71.1%). Tumour localisation was in the head in 76 (84.5%), multifocal in 3 (3.3%) and in the body/tail in 11 (12.2%). Pancreatic head resection was performed in 75 (83.3%), total pancreatectomy in 4 (4.4%) and distal pancreatectomy with splenectomy in 11 (12.2%), with standard lymphadenectomy. Venous resection was in 4 (4.4%). Thirty-day and in-hospital mortality occurred in 1 (1.1%), 90-day mortality was 3.3%. On univariate analysis absence of perineural and vascular invasion, stage, absence of lymph node infiltration and no need for transfusion were associated with improved overall survival. On multivariate analysis vascular invasion HR=3.137 (95%CI: 1.692-5.816; P = 0.0003) and postoperative complications HR=2.004 (95%CI: 1.198-3.354; P = 0.008) were identified as significant independent predictors of survival. The five-year survival rate was 18.9%, with five-year recurrence-free survival of 16.7%.
  
  
  CONCLUSIONS
  Vascular invasion and postoperative complications were independent prognostic factors after curative resections of pancreatic cancer in studied cohort.
authors.affiliation: Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Lovecek
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Skalicky
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Czech Republic.
authors.forename: Dusan
authors.initials: D
authors.lastname: Klos
authors.affiliation: Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Linda
authors.initials: L
authors.lastname: Bebarova
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Czech Republic.
authors.forename: Cestmir
authors.initials: C
authors.lastname: Neoral
authors.affiliation: Department of Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Ehrmann
authors.affiliation: Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Zapletalova
authors.affiliation: Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Svebisova
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Vrba
authors.affiliation: Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Stasek
authors.affiliation: Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
authors.forename: Tharani
authors.initials: T
authors.lastname: Yogeswara
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Havlik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation / Q000401:mortality; D017741:Survivors
keywords: complications; long term survival; pancreatic ductal adenocarcinoma; surgical therapy