The Oncologic Impact of Pancreatic Fistula After Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma of the Body and the Tail: A Multicenter Retrospective Cohort Analysis

Objectives The aim of this study was to assess the impact of clinically relevant postoperative pancreatic fistula (CR-POPF) on patient disease-specific survival and recurrence after curative distal pancreatectomy (DP) for pancreatic cancer. Design This was a retrospective case-control analysis. Meth...

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Published inAnnals of surgical oncology Vol. 28; no. 6; pp. 3171 - 3183
Main Authors Leon, Piera, Giannone, Fabio, Belfiori, Giulio, Falconi, Massimo, Crippa, Stefano, Boggi, Ugo, Menonna, Francesca, Al Sadairi, Abdul Rahman, Piardi, Tullio, Sulpice, Laurent, Gardini, Andrea, Sega, Valentina, Chirica, Mircea, Ravazzoni, Ferruccio, Giannandrea, Giusy, Pessaux, Patrick, de Blasi, Vito, Navarro, Francis, Panaro, Fabrizio
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.06.2021
Springer Nature B.V
Springer Verlag
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Summary:Objectives The aim of this study was to assess the impact of clinically relevant postoperative pancreatic fistula (CR-POPF) on patient disease-specific survival and recurrence after curative distal pancreatectomy (DP) for pancreatic cancer. Design This was a retrospective case-control analysis. Methods We examined the data of adult patients with a diagnosis of pancreatic ductal adenocarcinoma (PDAC) of the body and tail of the pancreas undergoing curative DP, over a 10-year period in 12 European surgical departments, from a prospectively implemented database. Results Among the 382 included patients, 283 met the strict inclusion criteria; 139 were males (49.1%) and the median age of the entire population was 70 years (range 37–88). A total of 121 POPFs were observed (42.8%), 42 (14.9%) of which were CR-POPFs. The median follow-up period was 24 months (range 3–120). Although poorer in the POPF group, overall survival (OS) and disease-free survival (DFS) did not differ significantly between patients with and without CR-POPF ( p  = 0.224 and p  = 0.165, respectively). CR-POPF was not significantly associated with local or peritoneal recurrence ( p  = 0.559 and p  = 0.302, respectively). A smaller percentage of patients benefited from adjuvant chemotherapy after POPF (76.2% vs. 83.8%), but the difference was not significant ( p  = 0.228). Conclusions CR-POPF is a major complication after DP but it did not affect the postoperative therapeutic path or long-term oncologic outcomes. CR-POPF was not a predictive factor for disease recurrence and was not associated with an increased incidence of peritoneal or local relapse. Trial Registration ClinicalTrials.gov ID: NCT04348084
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ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-020-09310-y