Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection

Kimberly A. Varker, Peter Muscarella, Kristian Wall, Christopher Ellison, Mark Bloomston

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Pancreatectomy has a high morbidity but remains the only chance of cure for pancreatic cancer. Its efficacy for non-pancreatic malignancies is less clear. We reviewed our experience with pancreatectomy for non-pancreatic malignancies to determine outcomes and identify predictors of survival. Patients and methods: The records of patients who underwent pancreatectomy for non-pancreatic malignancies between 1990 and 2005 were reviewed. Survival curves were constructed using the Kaplan-Meier method and compared using log-rank analysis. Cox proportional hazards was used to identify predictors of survival. Results: 29 patients (18 M/11 F) with a mean age of 59.9 years (range 29-86) underwent pancreatectomy for non-pancreatic malignancies. 19 (66%) primary malignancies were GI in origin. Most operations were undertaken with curative intent (76%), whereas the remainder was for symptom palliation. Pancreatectomy was completed for metastatic disease in 7 patients (24%) or en bloc to achieve negative margins in 22 patients (76%). Complete (i.e., R0) resection was achieved in 17 (59%). Perioperative mortality was 3%. Median follow-up was 15 months (range 7-172). Median overall survival was 12 months with 1-year survival of 48%. Significant predictors of improved survival by univariate analysis were R0 resection, non-GI primary, and pancreatic metastasectomy (vs. en bloc resection). Only R0 resection was predictive of long-term survival by multivariate analysis (median 21 months vs. 6). Conclusion: Pancreatic resection for non-pancreatic malignancies can be completed with minimal mortality. However, incomplete resection results in poor overall survival. Pancreatectomy for non-pancreatic malignancies should only be undertaken if complete resection is possible.

Original languageEnglish (US)
Article number145
JournalWorld Journal of Surgical Oncology
Volume5
DOIs
StatePublished - Dec 27 2007
Externally publishedYes

Fingerprint

Pancreatectomy
Survival
Neoplasms
Survival Analysis
Metastasectomy
Mortality
Pancreatic Neoplasms
Multivariate Analysis
Morbidity

ASJC Scopus subject areas

  • Cancer Research
  • Surgery

Cite this

Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection. / Varker, Kimberly A.; Muscarella, Peter; Wall, Kristian; Ellison, Christopher; Bloomston, Mark.

In: World Journal of Surgical Oncology, Vol. 5, 145, 27.12.2007.

Research output: Contribution to journalArticle

Varker, Kimberly A. ; Muscarella, Peter ; Wall, Kristian ; Ellison, Christopher ; Bloomston, Mark. / Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection. In: World Journal of Surgical Oncology. 2007 ; Vol. 5.
@article{860799aa623141578e9945b4a7e046c2,
title = "Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection",
abstract = "Background: Pancreatectomy has a high morbidity but remains the only chance of cure for pancreatic cancer. Its efficacy for non-pancreatic malignancies is less clear. We reviewed our experience with pancreatectomy for non-pancreatic malignancies to determine outcomes and identify predictors of survival. Patients and methods: The records of patients who underwent pancreatectomy for non-pancreatic malignancies between 1990 and 2005 were reviewed. Survival curves were constructed using the Kaplan-Meier method and compared using log-rank analysis. Cox proportional hazards was used to identify predictors of survival. Results: 29 patients (18 M/11 F) with a mean age of 59.9 years (range 29-86) underwent pancreatectomy for non-pancreatic malignancies. 19 (66{\%}) primary malignancies were GI in origin. Most operations were undertaken with curative intent (76{\%}), whereas the remainder was for symptom palliation. Pancreatectomy was completed for metastatic disease in 7 patients (24{\%}) or en bloc to achieve negative margins in 22 patients (76{\%}). Complete (i.e., R0) resection was achieved in 17 (59{\%}). Perioperative mortality was 3{\%}. Median follow-up was 15 months (range 7-172). Median overall survival was 12 months with 1-year survival of 48{\%}. Significant predictors of improved survival by univariate analysis were R0 resection, non-GI primary, and pancreatic metastasectomy (vs. en bloc resection). Only R0 resection was predictive of long-term survival by multivariate analysis (median 21 months vs. 6). Conclusion: Pancreatic resection for non-pancreatic malignancies can be completed with minimal mortality. However, incomplete resection results in poor overall survival. Pancreatectomy for non-pancreatic malignancies should only be undertaken if complete resection is possible.",
author = "Varker, {Kimberly A.} and Peter Muscarella and Kristian Wall and Christopher Ellison and Mark Bloomston",
year = "2007",
month = "12",
day = "27",
doi = "10.1186/1477-7819-5-145",
language = "English (US)",
volume = "5",
journal = "World Journal of Surgical Oncology",
issn = "1477-7819",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection

AU - Varker, Kimberly A.

AU - Muscarella, Peter

AU - Wall, Kristian

AU - Ellison, Christopher

AU - Bloomston, Mark

PY - 2007/12/27

Y1 - 2007/12/27

N2 - Background: Pancreatectomy has a high morbidity but remains the only chance of cure for pancreatic cancer. Its efficacy for non-pancreatic malignancies is less clear. We reviewed our experience with pancreatectomy for non-pancreatic malignancies to determine outcomes and identify predictors of survival. Patients and methods: The records of patients who underwent pancreatectomy for non-pancreatic malignancies between 1990 and 2005 were reviewed. Survival curves were constructed using the Kaplan-Meier method and compared using log-rank analysis. Cox proportional hazards was used to identify predictors of survival. Results: 29 patients (18 M/11 F) with a mean age of 59.9 years (range 29-86) underwent pancreatectomy for non-pancreatic malignancies. 19 (66%) primary malignancies were GI in origin. Most operations were undertaken with curative intent (76%), whereas the remainder was for symptom palliation. Pancreatectomy was completed for metastatic disease in 7 patients (24%) or en bloc to achieve negative margins in 22 patients (76%). Complete (i.e., R0) resection was achieved in 17 (59%). Perioperative mortality was 3%. Median follow-up was 15 months (range 7-172). Median overall survival was 12 months with 1-year survival of 48%. Significant predictors of improved survival by univariate analysis were R0 resection, non-GI primary, and pancreatic metastasectomy (vs. en bloc resection). Only R0 resection was predictive of long-term survival by multivariate analysis (median 21 months vs. 6). Conclusion: Pancreatic resection for non-pancreatic malignancies can be completed with minimal mortality. However, incomplete resection results in poor overall survival. Pancreatectomy for non-pancreatic malignancies should only be undertaken if complete resection is possible.

AB - Background: Pancreatectomy has a high morbidity but remains the only chance of cure for pancreatic cancer. Its efficacy for non-pancreatic malignancies is less clear. We reviewed our experience with pancreatectomy for non-pancreatic malignancies to determine outcomes and identify predictors of survival. Patients and methods: The records of patients who underwent pancreatectomy for non-pancreatic malignancies between 1990 and 2005 were reviewed. Survival curves were constructed using the Kaplan-Meier method and compared using log-rank analysis. Cox proportional hazards was used to identify predictors of survival. Results: 29 patients (18 M/11 F) with a mean age of 59.9 years (range 29-86) underwent pancreatectomy for non-pancreatic malignancies. 19 (66%) primary malignancies were GI in origin. Most operations were undertaken with curative intent (76%), whereas the remainder was for symptom palliation. Pancreatectomy was completed for metastatic disease in 7 patients (24%) or en bloc to achieve negative margins in 22 patients (76%). Complete (i.e., R0) resection was achieved in 17 (59%). Perioperative mortality was 3%. Median follow-up was 15 months (range 7-172). Median overall survival was 12 months with 1-year survival of 48%. Significant predictors of improved survival by univariate analysis were R0 resection, non-GI primary, and pancreatic metastasectomy (vs. en bloc resection). Only R0 resection was predictive of long-term survival by multivariate analysis (median 21 months vs. 6). Conclusion: Pancreatic resection for non-pancreatic malignancies can be completed with minimal mortality. However, incomplete resection results in poor overall survival. Pancreatectomy for non-pancreatic malignancies should only be undertaken if complete resection is possible.

UR - http://www.scopus.com/inward/record.url?scp=39649098672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39649098672&partnerID=8YFLogxK

U2 - 10.1186/1477-7819-5-145

DO - 10.1186/1477-7819-5-145

M3 - Article

VL - 5

JO - World Journal of Surgical Oncology

JF - World Journal of Surgical Oncology

SN - 1477-7819

M1 - 145

ER -