AISP - 36^th National Congress. Bologna, Italy. October 4-6, 2012

Tumor Size and Diabetes Are the Most Important Pre-Operative Prognostic Factors Influencing Survival After Pancreaticoduodenectomy in Pancreas Cancer Patients

Marco Del Chiaro, Elena Rangelova, Christoph Ansorge, John Blomberg, Ralf Segersvärd

Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Context The median survival in resected pancreatic ductal adenocarcinoma (PDAC) is about two years. However, a considerable percentage of patients die within the first year after resection. Objective The aim of this study was to evaluate pre-operative factors predicting a short survival after pancreaticoduodenectomy (PD) for PDAC. Methods One hundred consecutive patients undergone PD for PDAC without in-hospital mortality from October 2006 to July 2010 were retrieved from our prospective database. The cohort was divided by survival into short term (≤12 months: group A) and long term (>12 months: group B) survivors and evaluated regarding pre-operative factors including age, weight loss, BMI, tumor size and proximity (no contact-contact) to the portal/mesenteric vein (PV/SMV). Results No significant differences were found between group A (n=27) and group B (n=73) regarding mean age (68±2 vs. 66±1 years; P=0.3), weight loss (87% vs. 85%; P=1.0), BMI (24±0.6 kg/m² vs. 24±0.5 kg/m²; P=0.7) or adjuvant treatment. Group A had bigger tumors (35±2 mm vs. 29±1 mm; P=0.01) but no significant difference in proximity of the tumor to the PV/SMV (contact: A 67% vs. B 49%; P=0.2) or venous resections. Group A had more frequently pre-operative diabetes (33% vs. 9.6%; P=0.01) compared to group B. Conclusion Tumor size and pre-operative diabetes seems to be important negative prognostic factors for survival after PD for PDAC.