The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma
Background. The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal cholangiocarcinoma (DCC) patients to identify potential prognostic factors. Patients and Methods. A retrospective cohort study of 32 consecutive DCC patients treated with panc...
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| Format: | Article |
| Language: | English |
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Palacký University Olomouc, Faculty of Medicine and Dentistry
2022-12-01
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| Series: | Biomedical Papers |
| Subjects: | |
| Online Access: | https://biomed.papers.upol.cz/artkey/bio-202204-0005_the-short-and-long-term-outcomes-of-pancreaticoduodenectomy-for-distal-cholangiocarcinoma.php |
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| author | Pavel Skalicky Ondrej Urban Jiri Ehrmann Hana Svebisova Dusan Klos Jana Tesarikova Cestmir Neoral Katerina Knapkova Martin Lovecek |
| author_facet | Pavel Skalicky Ondrej Urban Jiri Ehrmann Hana Svebisova Dusan Klos Jana Tesarikova Cestmir Neoral Katerina Knapkova Martin Lovecek |
| author_sort | Pavel Skalicky |
| collection | DOAJ |
| description | Background. The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal cholangiocarcinoma (DCC) patients to identify potential prognostic factors. Patients and Methods. A retrospective cohort study of 32 consecutive DCC patients treated with pancreaticoduodenectomy between 2009-2017. The clinicopathological and histopathological data were evaluated for prognostic factors using the univariable Cox regression analysis. The Overall Survival (OS) was estimated using the Kaplan-Meier analysis. Results. The study comprised a total of 32 patients, with a mean age of 65.8 (± 9.0) years at the time of surgery. R0 resection was achieved in 25 (86.2%) patients, 19 (65.5%) patients received adjuvant oncological therapy. The OS rates at 1, 3 and 5 years were 62.5%, 37.5% and 21.9%, respectively. The 90-day mortality was 3/32 (9.4%) accounting for one-fourth of the first-year mortality rate. The median OS was 28.5 months. The only statistically significant prognostic factor was vascular resection, which was associated with worse OS in the univariable analysis (HR: 3.644; 95%-CI: 1.179-11.216, P=0.025). An age less than 65 years, ASA grade I/II, hospital stay of fewer than 15 days, R0 resection, lymph node ratio less than 0.2 and adjuvant oncological therapy tended to be associated with better OS but without statistically significant relevance. Conclusion. The main factor directly influencing the survival of DCC patients is surgical complications. Surgical mortality comprises a significant group of patients, who die in the first year following pancreaticoduodenectomy. Vascular resection is the most important negative prognostic factor for long-term survival. |
| first_indexed | 2024-04-12T01:44:16Z |
| format | Article |
| id | doaj.art-b340574b087048e38c4ef288dbaa1a4c |
| institution | Directory Open Access Journal |
| issn | 1213-8118 1804-7521 |
| language | English |
| last_indexed | 2024-04-12T01:44:16Z |
| publishDate | 2022-12-01 |
| publisher | Palacký University Olomouc, Faculty of Medicine and Dentistry |
| record_format | Article |
| series | Biomedical Papers |
| spelling | doaj.art-b340574b087048e38c4ef288dbaa1a4c2022-12-22T03:53:07ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212022-12-01166438639210.5507/bp.2021.043bio-202204-0005The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinomaPavel Skalicky0Ondrej Urban1Jiri Ehrmann2Hana Svebisova3Dusan Klos4Jana Tesarikova5Cestmir Neoral6Katerina Knapkova7Martin Lovecek8Department of Surgery I, University Hospital Olomouc, Czech RepublicDepartment of Internal Medicine II - Gastroenterology and Geriatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Oncology, University Hospital Olomouc, Czech RepublicDepartment of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Surgery I, University Hospital Olomouc, Czech RepublicDepartment of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Surgery I, University Hospital Olomouc, Czech RepublicBackground. The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal cholangiocarcinoma (DCC) patients to identify potential prognostic factors. Patients and Methods. A retrospective cohort study of 32 consecutive DCC patients treated with pancreaticoduodenectomy between 2009-2017. The clinicopathological and histopathological data were evaluated for prognostic factors using the univariable Cox regression analysis. The Overall Survival (OS) was estimated using the Kaplan-Meier analysis. Results. The study comprised a total of 32 patients, with a mean age of 65.8 (± 9.0) years at the time of surgery. R0 resection was achieved in 25 (86.2%) patients, 19 (65.5%) patients received adjuvant oncological therapy. The OS rates at 1, 3 and 5 years were 62.5%, 37.5% and 21.9%, respectively. The 90-day mortality was 3/32 (9.4%) accounting for one-fourth of the first-year mortality rate. The median OS was 28.5 months. The only statistically significant prognostic factor was vascular resection, which was associated with worse OS in the univariable analysis (HR: 3.644; 95%-CI: 1.179-11.216, P=0.025). An age less than 65 years, ASA grade I/II, hospital stay of fewer than 15 days, R0 resection, lymph node ratio less than 0.2 and adjuvant oncological therapy tended to be associated with better OS but without statistically significant relevance. Conclusion. The main factor directly influencing the survival of DCC patients is surgical complications. Surgical mortality comprises a significant group of patients, who die in the first year following pancreaticoduodenectomy. Vascular resection is the most important negative prognostic factor for long-term survival.https://biomed.papers.upol.cz/artkey/bio-202204-0005_the-short-and-long-term-outcomes-of-pancreaticoduodenectomy-for-distal-cholangiocarcinoma.phpcholangiocarcinomapancreaticoduodenectomylong-term survivalprognostic factor |
| spellingShingle | Pavel Skalicky Ondrej Urban Jiri Ehrmann Hana Svebisova Dusan Klos Jana Tesarikova Cestmir Neoral Katerina Knapkova Martin Lovecek The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma Biomedical Papers cholangiocarcinoma pancreaticoduodenectomy long-term survival prognostic factor |
| title | The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| title_full | The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| title_fullStr | The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| title_full_unstemmed | The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| title_short | The short- and long-term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| title_sort | short and long term outcomes of pancreaticoduodenectomy for distal cholangiocarcinoma |
| topic | cholangiocarcinoma pancreaticoduodenectomy long-term survival prognostic factor |
| url | https://biomed.papers.upol.cz/artkey/bio-202204-0005_the-short-and-long-term-outcomes-of-pancreaticoduodenectomy-for-distal-cholangiocarcinoma.php |
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