TY - JOUR
T1 - Preoperative Chemotherapy Does Not Adversely Affect Pancreatic Structure and Short-Term Outcome after Pancreatectomy
AU - Pecorelli, Nicolò
AU - Braga, Marco
AU - Doglioni, Claudio
AU - Balzano, Gianpaolo
AU - Reni, Michele
AU - Cereda, Stefano
AU - Albarello, Luca
AU - Castoldi, Renato
AU - Capretti, Giovanni
AU - Di Carlo, Valerio
PY - 2013
Y1 - 2013
N2 - Background: Preoperative chemotherapy (PCHT) has recently been proposed also in patients with resectable pancreatic adenocarcinoma. Few data are currently available on the impact of PCHT on short-term postoperative outcome after pancreatic resection. The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection. Methods: Fifty consecutive patients successfully underwent resection after PCHT. Each patient was matched with two control patients with pancreatic adenocarcinoma selected from our prospective electronic database. Match criteria were age (±3 years), gender, American Society of Anesthesiologist score, type of resection, pancreatic duct diameter (±1 mm), and tumor size (±5 mm). Primary endpoint was morbidity rate. Secondary endpoints were pancreatic parenchymal structure, mortality rate, and length of hospital stay (LOS). Results: Both degree of fibrosis and fatty infiltration of the pancreas were similar in the two groups. Overall morbidity rate was 48. 0 % in the PCHT group vs. 54. 0 % in the control group (p = 0. 37). Pancreatic fistula rate was 18. 0 % in the PCHT group vs. 25. 0 % in the control group (p = 0. 41). Mortality was 4. 0 % in the PCHT group vs. 2. 0 % in the control group (p = 0. 60). Mean LOS (days) was 12. 7 in the PCHT group vs. 12. 4 in the control group (p = 0. 74). There was no difference in resection margin status, while the rate of patients without nodal involvement was higher in the PCHT group (46. 0 vs. 23. 0 %, p = 0. 004). Conclusion: PCHT did not induce significant structural changes in pancreatic parenchyma and did not adversely affect short-term outcome after surgery.
AB - Background: Preoperative chemotherapy (PCHT) has recently been proposed also in patients with resectable pancreatic adenocarcinoma. Few data are currently available on the impact of PCHT on short-term postoperative outcome after pancreatic resection. The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection. Methods: Fifty consecutive patients successfully underwent resection after PCHT. Each patient was matched with two control patients with pancreatic adenocarcinoma selected from our prospective electronic database. Match criteria were age (±3 years), gender, American Society of Anesthesiologist score, type of resection, pancreatic duct diameter (±1 mm), and tumor size (±5 mm). Primary endpoint was morbidity rate. Secondary endpoints were pancreatic parenchymal structure, mortality rate, and length of hospital stay (LOS). Results: Both degree of fibrosis and fatty infiltration of the pancreas were similar in the two groups. Overall morbidity rate was 48. 0 % in the PCHT group vs. 54. 0 % in the control group (p = 0. 37). Pancreatic fistula rate was 18. 0 % in the PCHT group vs. 25. 0 % in the control group (p = 0. 41). Mortality was 4. 0 % in the PCHT group vs. 2. 0 % in the control group (p = 0. 60). Mean LOS (days) was 12. 7 in the PCHT group vs. 12. 4 in the control group (p = 0. 74). There was no difference in resection margin status, while the rate of patients without nodal involvement was higher in the PCHT group (46. 0 vs. 23. 0 %, p = 0. 004). Conclusion: PCHT did not induce significant structural changes in pancreatic parenchyma and did not adversely affect short-term outcome after surgery.
KW - Neoadjuvant chemotherapy
KW - Pancreatic adenocarcinoma
KW - Pancreatic structure
KW - Postoperative morbidity
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U2 - 10.1007/s11605-012-2063-7
DO - 10.1007/s11605-012-2063-7
M3 - Article
C2 - 23132627
AN - SCOPUS:84873746736
VL - 17
SP - 488
EP - 493
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 3
ER -