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Journal of Gastrointestinal Surgery

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01-02-2012 | Original Article

Pancreatic Adenocarcinoma: Complete Tumor Extirpation Improves Survival Benefit Despite Larger Tumors for Patients Who Undergo Distal Pancreatectomy and Splenectomy

Authors: Paul Toomey, Jonathan Hernandez, Farhaad Golkar, Sharona Ross, Kenneth Luberice, Alexander Rosemurgy

Published in: Journal of Gastrointestinal Surgery | Issue 2/2012

Abstract

Introduction

Patients with pancreatic adenocarcinoma have poor survival. Presumably, tumors in the body or tail of the pancreas, due to paucity of symptoms, present later than patients with tumors in the head of the pancreas. This study was undertaken to determine if tumors amenable to complete extirpation by distal pancreatectomy/splenectomy have worse survival when compared to their proximal counterparts.

Methods

Since 1992, patients undergoing pancreaticoduodenectomy or distal pancreatectomy/splenectomy for pancreatic adenocarcinoma have been prospectively followed. The impact of resection was evaluated using a survival curve analysis (Mantel–Cox). Data are presented as median, mean ± SD.

Results

Two hundred twenty patients underwent pancreaticoduodenectomy and 33 patients underwent distal pancreatectomy/splenectomy for pancreatic adenocarcinoma. Comparing overall survival, there was not a significant difference between patients undergoing pancreaticoduodenectomy (16.8 months, 25.6 ± 26) and distal pancreatectomy/splenectomy (15.2 months, 19.7 ± 18.6), p = 0.34. Patients undergoing distal pancreatectomy/splenectomy had significantly larger tumors (4 cm, 5 ± 2.3) compared to patients undergoing pancreaticoduodenectomy (3 cm, 3 ± 1.4), p = 0.005.

Conclusion

Long-term survival after resection of pancreatic adenocarcinoma is poor despite the location within the pancreas. Complete tumor extirpation continues to be an independent predictor of survival, regardless of operation undertaken, despite larger tumors for patients who undergo distal pancreatectomy/splenectomy.

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Title: Pancreatic Adenocarcinoma: Complete Tumor Extirpation Improves Survival Benefit Despite Larger Tumors for Patients Who Undergo Distal Pancreatectomy and Splenectomy
Authors: Paul Toomey
Jonathan Hernandez
Farhaad Golkar
Sharona Ross
Kenneth Luberice
Alexander Rosemurgy
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 2/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1765-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pancreatic Adenocarcinoma: Complete Tumor Extirpation Improves Survival Benefit Despite Larger Tumors for Patients Who Undergo Distal Pancreatectomy and Splenectomy

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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