• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (17)  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in this journal  Topic Collections  • Oncology  • Oncology, Other  • Surgery  • Surgical Interventions  • Endocrine Surgery  • Surgical Oncology  • Surgical Physiology  • Blood/ Coagulation  • Prognosis/ Outcomes  • Gastroenterology  • Liver/ Biliary Tract/ Pancreatic Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

The Influence of Operative Blood Loss

Kevork K. Kazanjian, MD; O. Joe Hines, MD; John P. Duffy, MD; Diana Y. Yoon, MD; Galen Cortina, MD, PhD; Howard A. Reber, MD

Arch Surg. 2008;143(12):1166-1171.

Hypothesis  Although the safety of pancreaticoduodenectomy has notably improved over the past several decades, the reported survival of patients with pancreatic cancer remains poor. We hypothesized that, in recent years, the survival of patients with pancreatic adenocarcinoma following pancreaticoduodenectomy has substantially improved.

Design  Retrospective case series.

Setting  Major academic medical and pancreatic surgery center.

Patients  A total of 182 consecutive patients underwent pancreaticoduodenectomy for various diagnoses between 1987 and 2005. Patients from 1987-1995 were compared with patients from 1996-2005.

Interventions  Pancreaticoduodenectomy for patients with a diagnosis of pancreatic adenocarcinoma.

Main Outcome Measures  Survival after pancreaticoduodenectomy and patient outcomes.

Results  During the time period analyzed, 182 patients underwent pancreaticoduodenectomy to treat ductal adenocarcinoma. There were no operative deaths, and 86.3% of patients had an R0 resection. The 5-year survival rate for the entire group was 27.4%. However, survival improved from 15.8% to 35.5% during the study period. Both groups had equivalent demographic and pathological characteristics, and the only predictors of poor survival in multivariate analysis were operative blood loss of more than 400 mL (hazard ratio, 2.17), poorly differentiated tumors (3.03), lymph node metastases (1.92), perineural invasion (2.66), and undergoing an operation before 1996 (1.42).

Conclusions  The survival rate for patients undergoing pancreaticoduodenectomy to treat pancreatic cancer has substantially improved. This finding is partially owing to improved operative technique and limited operative blood loss.

Author Affiliations: Section of Gastrointestinal Surgery, Department of Surgery (Drs Kazanjian, Hines, Duffy, Yoon, and Reber), and Department of Pathology (Dr Cortina), David Geffen School of Medicine, University of California, Los Angeles.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Operative Blood Loss and Survival in Pancreatic Cancer
William Charles Conway and Singh Gagandeep
Arch Surg. 2009;144(6):594.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Downstaging Chemotherapy and Alteration in the Classic Computed Tomography/Magnetic Resonance Imaging Signs of Vascular Involvement in Patients With Pancreaticobiliary Malignant Tumors: Influence on Patient Selection for Surgery
Donahue et al.
Arch Surg 2011;146:836-843.
ABSTRACT | FULL TEXT  

Operative Blood Loss and Survival in Pancreatic Cancer
Conway and Gagandeep
Arch Surg 2009;144:594-594.
FULL TEXT