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BMC Surgery
Published in: BMC Surgery 1/2024

Open Access 01-12-2024 | Pancreatic Cancer | Research

Perioperative factors associated with survival following surgery for pancreatic cancer – a nationwide analysis of 473 cases from Denmark.

Authors: Laura Marr Spore, Emilie Even Dencker, Eske Aasvang Kvanner, Carsten Palnaes Hansen, Stefan Kobbelgaard Burgdorf, Paul Suno Krohn, Sophie Louise Gisela Kollbeck, Jan Henrik Storkholm, Martin Sillesen

Published in: BMC Surgery | Issue 1/2024

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Abstract

Background

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal cancers worldwide, with an overall 5-year survival rate of only 5%. The effect of perioperative treatment factors including duration of surgery, blood transfusions as well as choice of anesthesia and analgesia techniques on overall survival (OS) following pancreatic resections for PDAC, is currently not well known. We hypothesized that these perioperative factors might be associated with OS after pancreatic resections for PDAC.

Methods

This is a retrospective study from a nationwide cohort of patients who underwent surgery for PDAC in Denmark from 2011 to 2020. Kaplan-Meier 1, 2 and 5-year survival estimates were 73%, 49% and 22%, respectively. Data were obtained by joining the national Danish Pancreatic Cancer Database (DPCD) and the Danish Anaesthesia Database (DAD). Associations between the primary endpoint (OS) and perioperative factors including duration of surgery, type of anesthesia (intravenous, inhalation or mixed), use of epidural analgesia and perioperative blood transfusions were assessed using Hazard Ratios (HRs). These were calculated by Cox regression, controlling for relevant confounders identified through an assessment of the current literature. These included demographics, comorbidities, perioperative information, pre and postoperative chemotherapy, tumor staging and free resection margins.

Results

Overall, data from 473 resected PDAC patients were available. Multivariate Cox regression indicated that perioperative blood transfusions were associated with shorter OS (HR 2.53, p = 0.005), with survival estimates of 8.8% in transfused vs. 28.0% in non-transfused patients at 72 months after surgery. No statistically significant associations were identified for the duration of surgery or anesthesia/analgesia techniques.

Conclusion

In this study, the use of perioperative blood transfusions was associated with shorter OS.
Appendix
Available only for authorised users
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Metadata
Title
Perioperative factors associated with survival following surgery for pancreatic cancer – a nationwide analysis of 473 cases from Denmark.
Authors
Laura Marr Spore
Emilie Even Dencker
Eske Aasvang Kvanner
Carsten Palnaes Hansen
Stefan Kobbelgaard Burgdorf
Paul Suno Krohn
Sophie Louise Gisela Kollbeck
Jan Henrik Storkholm
Martin Sillesen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2024
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-024-02369-4

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