title: Effect of postoperative major complications on prognosis after pancreatectomy for pancreatic cancer: a retrospective review.
abstract: OBJECTIVE
  To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer.
  
  
  METHODS
  We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien-Dindo classification.
  
  
  RESULTS
  Thirty-eight patients (31 %) suffered major postoperative complications and 40 patients (33 %) suffered minor complications only. Univariate survival analysis showed that patients with major complications had a significantly worse prognosis than those without major complications, with regard to recurrence-free survival (RFS) (P < 0.01) and overall survival (OS) (P < 0.01), whereas minor complications did not affect survival. Major complications significantly inhibited or delayed adjuvant chemotherapy. Multivariate survival analysis showed that the absence of postoperative major complications was an independent favorable factor for RFS (hazard ratio 0.48; 95 % confidence interval: 0.28-0.85) and OS (hazard ratio 0.47; 95 % confidence interval 0.27-0.81).
  
  
  CONCLUSIONS
  Postoperative major complications after pancreatectomy for pancreatic cancer affect the prognosis.
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan. wyuusuke@surg1.med.kyushu-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nishihara
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
authors.forename: Sokichi
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Okayama
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, 802-0077, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010185:Pancreatic Fistula; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors
keywords: Pancreatectomy; Pancreatic cancer; Postoperative complications; Prognosis; Survival