AI Article Synopsis
- Pancreatoduodenectomy, the main treatment for pancreatic and periampullary cancers, has serious complications but shows improving outcomes over time.* -
- A study in Sweden followed 5,923 patients from 1964 to 2016, revealing a significant drop in postoperative deaths from 17.2% to 1.6% over the decades.* -
- Survival rates also improved notably; from 2010-2016, 5-year survival rates varied by cancer type, with up to 71.2% for duodenal cancer and 29.0% for pancreatic cancer.*
Article Abstract
Background: Pancreatoduodenectomy is the only cure for cancers of the pancreas and the periampullary region but has considerable operative complications and uncertain prognosis. Our goal was to analyse temporal improvements and provide contemporary population-based benchmarks for outcomes following pancreatoduodenectomy.
Methods: We empanelled a cohort comprising all patients in Sweden with pancreatic or periampullary cancer treated with pancreatoduodenectomy from 1964 to 2016 and achieved complete follow-up through 2016. We analysed postoperative deaths and disease-specific net survival.
Results: We analysed 5923 patients with cancer of the pancreas (3876), duodenum (444), bile duct (504), or duodenal papilla (963) who underwent classic (3332) or modified (1652) Whipple's procedure or total pancreatectomy (803). Postoperative deaths declined from 17.2% in the 1960s to 1.6% in the contemporary time period (2010-2016). For all four cancer types, median, 1-year and 5-year survival improved substantially over time. Among patients operated between 2010 and 2016, 5-year survival was 29.0% (95% confidence interval (CI): 25.5, 33.0) for pancreatic cancer, 71.2% (95% CI: 62.9, 80.5) for duodenal cancer, 30.8% (95% CI: 23.0, 41.3) for bile duct cancer, and 62.7% (95% CI: 55.5, 70.8) for duodenal papilla cancer.
Conclusion: There is a continuous and substantial improvement in the benefit-harm ratio after pancreatoduodenectomy for cancer.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333598 | PMC |
| http://dx.doi.org/10.1038/s41416-024-02757-w | DOI Listing |
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