TY - JOUR
T1 - Acute Pancreatitis as the Initial Presentation of Pancreatic Adenocarcinoma does not Impact Short- and Long-term Outcomes of Curative Intent Surgery
T2 - A Study of the French Surgical Association
AU - Lupinacci, Renato Micelli
AU - Faron, Matthieu
AU - Bachellier, Philippe
AU - Sauvanet, Alain
AU - Beauchet, Alain
AU - Le Treut, Yves Patrice
AU - Adham, Mustapha
AU - Mabrut, Jean Yves
AU - Delpero, Jean Robert
AU - Paye, François
N1 - Publisher Copyright:
© 2021, Société Internationale de Chirurgie.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: Acute pancreatitis (AP) can be one of the earliest clinical presentation of pancreatic ductal adenocarcinoma (PDAC). Information about the impact of AP on postoperative outcomes as well as its influences on PDAC survival is scarce. This study aimed to determine whether AP as initial clinical presentation of PDAC impact the short- and long-term outcomes of curative intent pancreatic resection. Patients and methods: From 2004 to 2009, 1449 patients with PDAC underwent pancreatic resection in 37 institutions (France, Belgium and Switzerland). We used univariate and multivariate analysis to identify factors associated with severe complications and pancreatic fistula as well as overall and disease-free survivals. Results: There were 764 males (52,7%), and the median age was 64 years. A total of 781 patients (53.9%) developed at least one complication, among whom 317 (21.8%) were classified as Clavien–Dindo ≥ 3. A total of 114 (8.5%) patients had AP as the initial clinical manifestation of PDAC. This situation was not associated with any increase in the rates of postoperative fistula (21.2% vs 16.4%, P = 0.19), postoperative complications (57% vs 54.2%, P = 0.56), and 30 day mortality (2.6% vs 3.4%, P = 1). In multivariate analysis, AP did not correlate with postoperative complications or pancreatic fistula. The median length of follow-up was 22.4 months. The median overall survival after surgery was 29.9 months in the AP group and 30.5 months in the control group. Overall recurrence rate and local recurrence rate did not differ between groups. Conclusion: AP before PDAC resection did not impact postoperative morbidity and mortality, as well as recurrence rate and survival.
AB - Background: Acute pancreatitis (AP) can be one of the earliest clinical presentation of pancreatic ductal adenocarcinoma (PDAC). Information about the impact of AP on postoperative outcomes as well as its influences on PDAC survival is scarce. This study aimed to determine whether AP as initial clinical presentation of PDAC impact the short- and long-term outcomes of curative intent pancreatic resection. Patients and methods: From 2004 to 2009, 1449 patients with PDAC underwent pancreatic resection in 37 institutions (France, Belgium and Switzerland). We used univariate and multivariate analysis to identify factors associated with severe complications and pancreatic fistula as well as overall and disease-free survivals. Results: There were 764 males (52,7%), and the median age was 64 years. A total of 781 patients (53.9%) developed at least one complication, among whom 317 (21.8%) were classified as Clavien–Dindo ≥ 3. A total of 114 (8.5%) patients had AP as the initial clinical manifestation of PDAC. This situation was not associated with any increase in the rates of postoperative fistula (21.2% vs 16.4%, P = 0.19), postoperative complications (57% vs 54.2%, P = 0.56), and 30 day mortality (2.6% vs 3.4%, P = 1). In multivariate analysis, AP did not correlate with postoperative complications or pancreatic fistula. The median length of follow-up was 22.4 months. The median overall survival after surgery was 29.9 months in the AP group and 30.5 months in the control group. Overall recurrence rate and local recurrence rate did not differ between groups. Conclusion: AP before PDAC resection did not impact postoperative morbidity and mortality, as well as recurrence rate and survival.
UR - http://www.scopus.com/inward/record.url?scp=85108958130&partnerID=8YFLogxK
U2 - 10.1007/s00268-021-06205-1
DO - 10.1007/s00268-021-06205-1
M3 - Article
C2 - 34191085
AN - SCOPUS:85108958130
SN - 0364-2313
VL - 45
SP - 3146
EP - 3156
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 10
ER -