| Title: |
Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study |
| Authors: |
Russell, TB; Labib, PL; Denson, J; Ausania, F; Pando, E; Roberts, KJ; Kausar, A; Mavroeidis, VK; Marangoni, G; Thomasset, SC; Frampton, AE; Lykoudis, P; Maglione, M; Alhaboob, N; Bari, H; Smith, AM; Spalding, D; Srinivasan, P; Davidson, BR; Bhogal, RH; Croagh, D; Rajagopalan, A; Dominguez, I; Thakkar, R; Gomez, D; Silva, MA; Lapolla, P; Mingoli, A; Porcu, A; Perra, T; Shah, NS; Hamady, ZZR; Al-Sarrieh, B; Serrablo, A; RAW Study Collaborators; Aroori, S |
| Source: |
414 ; 403 |
| Publisher Information: |
Korean Association of Hepato-biliary-pancreatic Surgery |
| Publication Year: |
2023 |
| Collection: |
Imperial College London: Spiral |
| Subject Geographic: |
Korea (South) |
| Description: |
BACKGROUNDS/AIMS: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. METHODS: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). RESULTS: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-todeath (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p=0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. CONCLUSIONS: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Annals of Hepato-biliary-pancreatic Surgery; http://hdl.handle.net/10044/1/109898 |
| DOI: |
10.14701/ahbps.23-042 |
| Availability: |
http://hdl.handle.net/10044/1/109898; https://doi.org/10.14701/ahbps.23-042 |
| Rights: |
© 2023 The Korean Association of Hepato-Biliary-Pancreatic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ; http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.2AFA6582 |
| Database: |
BASE |