| 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, Thomas B.; Labib, Peter L.; Denson, Jemimah; Ausania, Fabio; Pando, Elizabeth; Roberts, Keith J.; Kausar, Ambareen; Mavroeidis, Vasileios K.; Marangoni, Gabriele; Thomasset, Sarah C.; Frampton, Adam E.; Lykoudis, Pavlos; Maglione, Manuel; Alhaboob, Nassir; Bari, Hassaan; Smith, Andrew M.; Spalding, Duncan; Srinivasan, Parthi; Davidson, Brian R.; Bhogal, Ricky H.; Croagh, Daniel; Rajagopalan, Ashray; Dominguez, Ismael; Thakkar, Rohan; Gomez, Dhanny; Silva, Michael A.; Lapolla, Pierfrancesco; Mingoli, Andrea; Porcu, Alberto; Perra, Teresa; Shah, Nehal S.; Hamady, Zaed Z.R.; Al-Sarrieh, Bilal; Serrablo, Alejandro; Aroori, Somaiah |
| Publication Year: |
2023 |
| Collection: |
University of Southampton: e-Prints Soton |
| 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 |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://eprints.soton.ac.uk/485382/1/ahbps_27_4_403.pdf; RAW Study Collaborators (2023) Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study. Annals of hepato-biliary-pancreatic surgery, 27 (4), 403-414. (doi:10.14701/ahbps.23-042 ). |
| Availability: |
https://eprints.soton.ac.uk/485382/; https://eprints.soton.ac.uk/485382/1/ahbps_27_4_403.pdf |
| Rights: |
cc_by_nc_4 |
| Accession Number: |
edsbas.739139D2 |
| Database: |
BASE |