Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma
Purpose The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas. Methods A retrospective analysis of consecutive patients diagnosed w...
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| Veröffentlicht in: | Journal of gastrointestinal cancer 2017-03, Vol.48 (1), p.13-19 |
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| creator | Sunil, Bhanu Jayanand Seshadri, Ramakrishnan A Gouthaman, S. Ranganathan, Rama |
| description | Purpose
The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas.
Methods
A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test. Factors identified to be significant in univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazard model. The survival estimates were calculated by life-table method. Statistical significance was considered when
p
value was |
| doi_str_mv | 10.1007/s12029-016-9863-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826742062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826742062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-f2801278155f0487cd03cb04f10b1f317edaf95db45688af4b31571b2d7710a83</originalsourceid><addsrcrecordid>eNp9kDFPwzAQhS0EoqXwA1hQRhaDz3FsZ0SFAlKldiiz5Th2laqJi50M9NfjqqUj05107z29-xC6B_IEhIjnCJTQEhPguJQ8x_sLNIaSAeY855fnncoRuolxQwhnBcA1GlHBJCslGaPXue_WeGVDmy2G3vjWxkx3dbYMft352Dcmm2nT-xCzpsuWNjS63Q3brQ4_2VQH03S-1bfoyulttHenOUFfs7fV9APPF--f05c5NgxYjx2VBKiQUBSOMClMTXJTEeaAVOByELbWrizqihVcSu1YlUMhoKK1EEC0zCfo8Zi7C_57sLFXbRONTW0664eoQFIuGCWcJikcpSb4GIN1aheaNrVWQNQBnjrCUwmeOsBT--R5OMUPVWvrs-OPVhLQoyCmU7e2QW38ELr08j-pv8q4ebA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1826742062</pqid></control><display><type>article</type><title>Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma</title><source>MEDLINE</source><source>SpringerLink Journals (MCLS)</source><creator>Sunil, Bhanu Jayanand ; Seshadri, Ramakrishnan A ; Gouthaman, S. ; Ranganathan, Rama</creator><creatorcontrib>Sunil, Bhanu Jayanand ; Seshadri, Ramakrishnan A ; Gouthaman, S. ; Ranganathan, Rama</creatorcontrib><description>Purpose
The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas.
Methods
A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test. Factors identified to be significant in univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazard model. The survival estimates were calculated by life-table method. Statistical significance was considered when
p
value was <0.05. The SPSS v16.0.1 software was used for statistical analysis.
Results
Between 1995 and 2010, 78 patients underwent PD with or without (Whipple’s operation) pylorus preservation for non-pancreatic periampullary adenocarcinomas. Of these, eight patients received adjuvant chemotherapy. The most common subsite was ampulla (60 patients), followed by the second part duodenum (11 patients), and distal common bile duct (7 patients). The median duration of follow-up of all patients in this study was 50 months. The recurrence rate was 39.7 %. The 5-year disease-free survival and overall survival was 57 %. Patients without nodal metastasis had a non-significant trend towards better 5-year disease-free survival when compared to those with nodal metastasis (64 vs 45 %,
p
= 0.11). On multivariate analysis, it was found that male gender (
p
= 0.05) and presence of lymphovascular invasion (
p
= 0.04) predicted a significantly poor 5-year disease-free survival.
Conclusion
Periampullary carcinomas have a favorable prognosis after surgery. Male gender and presence of lymphovascular invasion are independent prognostic factors in patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD in this study.</description><identifier>ISSN: 1941-6628</identifier><identifier>EISSN: 1941-6636</identifier><identifier>DOI: 10.1007/s12029-016-9863-z</identifier><identifier>PMID: 27484980</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Cancer Research ; Disease-Free Survival ; Female ; Gastroenterology ; Humans ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original Research ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - surgery ; Pancreaticoduodenectomy - mortality ; Prognosis ; Proportional Hazards Models ; Radiotherapy ; Retrospective Studies ; Survival Analysis ; Time ; Treatment Outcome</subject><ispartof>Journal of gastrointestinal cancer, 2017-03, Vol.48 (1), p.13-19</ispartof><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-f2801278155f0487cd03cb04f10b1f317edaf95db45688af4b31571b2d7710a83</citedby><cites>FETCH-LOGICAL-c414t-f2801278155f0487cd03cb04f10b1f317edaf95db45688af4b31571b2d7710a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12029-016-9863-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12029-016-9863-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27484980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sunil, Bhanu Jayanand</creatorcontrib><creatorcontrib>Seshadri, Ramakrishnan A</creatorcontrib><creatorcontrib>Gouthaman, S.</creatorcontrib><creatorcontrib>Ranganathan, Rama</creatorcontrib><title>Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma</title><title>Journal of gastrointestinal cancer</title><addtitle>J Gastrointest Canc</addtitle><addtitle>J Gastrointest Cancer</addtitle><description>Purpose
The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas.
Methods
A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test. Factors identified to be significant in univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazard model. The survival estimates were calculated by life-table method. Statistical significance was considered when
p
value was <0.05. The SPSS v16.0.1 software was used for statistical analysis.
Results
Between 1995 and 2010, 78 patients underwent PD with or without (Whipple’s operation) pylorus preservation for non-pancreatic periampullary adenocarcinomas. Of these, eight patients received adjuvant chemotherapy. The most common subsite was ampulla (60 patients), followed by the second part duodenum (11 patients), and distal common bile duct (7 patients). The median duration of follow-up of all patients in this study was 50 months. The recurrence rate was 39.7 %. The 5-year disease-free survival and overall survival was 57 %. Patients without nodal metastasis had a non-significant trend towards better 5-year disease-free survival when compared to those with nodal metastasis (64 vs 45 %,
p
= 0.11). On multivariate analysis, it was found that male gender (
p
= 0.05) and presence of lymphovascular invasion (
p
= 0.04) predicted a significantly poor 5-year disease-free survival.
Conclusion
Periampullary carcinomas have a favorable prognosis after surgery. Male gender and presence of lymphovascular invasion are independent prognostic factors in patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD in this study.</description><subject>Adult</subject><subject>Aged</subject><subject>Cancer Research</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Research</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreaticoduodenectomy - mortality</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Time</subject><subject>Treatment Outcome</subject><issn>1941-6628</issn><issn>1941-6636</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kDFPwzAQhS0EoqXwA1hQRhaDz3FsZ0SFAlKldiiz5Th2laqJi50M9NfjqqUj05107z29-xC6B_IEhIjnCJTQEhPguJQ8x_sLNIaSAeY855fnncoRuolxQwhnBcA1GlHBJCslGaPXue_WeGVDmy2G3vjWxkx3dbYMft352Dcmm2nT-xCzpsuWNjS63Q3brQ4_2VQH03S-1bfoyulttHenOUFfs7fV9APPF--f05c5NgxYjx2VBKiQUBSOMClMTXJTEeaAVOByELbWrizqihVcSu1YlUMhoKK1EEC0zCfo8Zi7C_57sLFXbRONTW0664eoQFIuGCWcJikcpSb4GIN1aheaNrVWQNQBnjrCUwmeOsBT--R5OMUPVWvrs-OPVhLQoyCmU7e2QW38ELr08j-pv8q4ebA</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Sunil, Bhanu Jayanand</creator><creator>Seshadri, Ramakrishnan A</creator><creator>Gouthaman, S.</creator><creator>Ranganathan, Rama</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma</title><author>Sunil, Bhanu Jayanand ; Seshadri, Ramakrishnan A ; Gouthaman, S. ; Ranganathan, Rama</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-f2801278155f0487cd03cb04f10b1f317edaf95db45688af4b31571b2d7710a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cancer Research</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Research</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreaticoduodenectomy - mortality</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>Time</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sunil, Bhanu Jayanand</creatorcontrib><creatorcontrib>Seshadri, Ramakrishnan A</creatorcontrib><creatorcontrib>Gouthaman, S.</creatorcontrib><creatorcontrib>Ranganathan, Rama</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sunil, Bhanu Jayanand</au><au>Seshadri, Ramakrishnan A</au><au>Gouthaman, S.</au><au>Ranganathan, Rama</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma</atitle><jtitle>Journal of gastrointestinal cancer</jtitle><stitle>J Gastrointest Canc</stitle><addtitle>J Gastrointest Cancer</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>48</volume><issue>1</issue><spage>13</spage><epage>19</epage><pages>13-19</pages><issn>1941-6628</issn><eissn>1941-6636</eissn><abstract>Purpose
The aim of the study was to analyze the long-term survival and the various prognostic factors that influence overall survival in patients undergoing pancreaticoduodenectomy (PD) with non-pancreatic periampullary carcinomas.
Methods
A retrospective analysis of consecutive patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD at a tertiary cancer center was performed. Univariate analysis of various prognostic factors influencing the disease-free survival (DFS) was performed using log-rank test. Factors identified to be significant in univariate analysis were included in the multivariate analysis, which was performed using the Cox proportional hazard model. The survival estimates were calculated by life-table method. Statistical significance was considered when
p
value was <0.05. The SPSS v16.0.1 software was used for statistical analysis.
Results
Between 1995 and 2010, 78 patients underwent PD with or without (Whipple’s operation) pylorus preservation for non-pancreatic periampullary adenocarcinomas. Of these, eight patients received adjuvant chemotherapy. The most common subsite was ampulla (60 patients), followed by the second part duodenum (11 patients), and distal common bile duct (7 patients). The median duration of follow-up of all patients in this study was 50 months. The recurrence rate was 39.7 %. The 5-year disease-free survival and overall survival was 57 %. Patients without nodal metastasis had a non-significant trend towards better 5-year disease-free survival when compared to those with nodal metastasis (64 vs 45 %,
p
= 0.11). On multivariate analysis, it was found that male gender (
p
= 0.05) and presence of lymphovascular invasion (
p
= 0.04) predicted a significantly poor 5-year disease-free survival.
Conclusion
Periampullary carcinomas have a favorable prognosis after surgery. Male gender and presence of lymphovascular invasion are independent prognostic factors in patients diagnosed with non-pancreatic periampullary carcinomas who underwent PD in this study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27484980</pmid><doi>10.1007/s12029-016-9863-z</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Cancer Research Disease-Free Survival Female Gastroenterology Humans Internal Medicine Male Medicine Medicine & Public Health Middle Aged Oncology Original Research Pancreatic Neoplasms - mortality Pancreatic Neoplasms - surgery Pancreaticoduodenectomy - mortality Prognosis Proportional Hazards Models Radiotherapy Retrospective Studies Survival Analysis Time Treatment Outcome |
| title | Long-Term Outcomes and Prognostic Factors in Periampullary Carcinoma |
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