Pancreatic surgery at the University Hospital Kralovske Vinohrady: 10-year review with a survival analysis for pancreatic ductal adenocarcinoma

Czech version

Authors: R. Gürlich ^1,2; A. Whitley ²; Z. Šubrt ²; M. Oliverius ²
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Bulovka, Praha, Česká republika ¹; Chirurgická klinika Fakultní nemocnice Královské Vinohrady, Praha, Česká republika ²
Published in: Rozhl. Chir., 2024, roč. 103, č. 4, s. 132-137.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2024.103.4.132–137

Overview

Introduction: The aim of the study was to summarize the results of pancreatic surgery over a ten-year period at the surgical department of the university hospital Kralovske Vinohrady and analyse the prognostic factors of pancreatic ductal adenocarcinoma.

Methods: From October 2012 to December 2022, 331 patients underwent proximal pancreatectomy, 142 patients underwent distal pancreatectomy, and 84 patients underwent total pancreatectomy. Of the total number of resected patients, the analysis was performed only in patients with proven findings of ductal adenocarcinoma of the pancreas (221 patients). Survival analysis was conducted using the Kaplan-Meier method, and prognostic factors were assessed using Cox analysis for these patients.

Results: The average length of hospitalization was 13 days (3–53 days). According to the Clavien-Dindo classification, 90 patients had an uncomplicated postoperative course, 65 had minor complications (grade I and II), and 66 patients had major complications (grade III-V). Based on TNM staging, 27 patients were in stage I, 136 in stage II, 41 in stage III, and 17 in stage IV. The median survival was 304 days. Overall, 1-, 2-, 3-, and 5-year survival rates were 62.7% (95% confidence interval (CI) 55.9%–70.4%), 39.0% (95% CI: 31.9–47.6%), 27.3% (95% CI: 20.7–36.0%), and 12.8% (95% CI: 6.9%–24.0%), respectively. Using the Cox model, the following negative prognostic factors were identified: severe postoperative complications, positive lymph nodes, T stage, and positive resection margins.

Conclusion: Pancreatic ductal adenocarcinoma is an aggressive tumour. Radical resection represents the only chance for long-term survival. The best results are achieved in specialized centres with a high volume of pancreatic resections.

Keywords:

pancreatic adenocarcinoma – pancreatic resection

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prof. MUDr. Robert Gürlich, CSc.
Chirurgická klinika
FN Bulovka
e-mail: robert.gurlich@bulovka.cz

Labels

Surgery Orthopaedics Trauma surgery

Ductal adenocarcinoma of the pancreas, a significant advance in treatment?

Pancreatic cancer – systemic treatment

Imaging methods in the diagnosis and treatment of pancreatic cancer

Minimal invasive surgery of pancreatic cancer at the Department of Surgery of Masaryk university hospital Brno, Czech Republic

Meckel‘s diverticulum as a cause of gastrointestinal bleeding in an adolescent patient

Article was published in

Perspectives in Surgery

2024 Issue 4