Abstract
Background: The impact of preoperative chemoradiation on postoperative morbidity and mortality of patients with pancreatic adenocarcinoma remains controversial. Methods: Consecutive pancreatectomies for adenocarcinoma performed between 2011 and 2015 were prospectively monitored for 90 days by using a previously reported surveillance system to determine the association between preoperative chemoradiation and adverse events, pancreatic fistulae, readmissions, and mortality. Results: Among 209 consecutive patients who underwent pancreatectomy, 159 (76 %) experienced at least one adverse event within 90 postoperative days. Patients who received preoperative chemoradiation (n = 137, 66 %) were more likely to have borderline resectable/locally advanced tumors, to have received induction chemotherapy, and to require vascular resection at pancreatectomy than those who did not receive chemoradiation (all P < 0.05). Nonetheless, there were no significant differences in the rates of severe complications, readmission, or mortality between these groups (all P > 0.05). Among patients who underwent pancreatoduodenectomy, the rate of pancreatic fistula was similar between those who received chemoradiation and those who did not (P = 0.96). In contrast, those who received chemoradiation prior to distal pancreatectomy had a lower rate of pancreatic fistula (P < 0.01). Conclusion: Preoperative chemoradiation is not associated with an increase in 90-day morbidity or mortality, and it may reduce the rate of pancreatic fistula following distal pancreatectomy.
Original language | English (US) |
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Pages (from-to) | 1975-1985 |
Number of pages | 11 |
Journal | Journal of Gastrointestinal Surgery |
Volume | 20 |
Issue number | 12 |
DOIs | |
State | Published - Dec 1 2016 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2016, The Society for Surgery of the Alimentary Tract.
Keywords
- Chemoradiation
- Morbidity
- Pancreatectomy
- Pancreatic adenocarcinoma
- Pancreatic fistula