Strategy of Pancreatectomies for Pancreatic Ductal Adenocarcinoma in Patients with a History of Gastrectomy
Recently, the incidence of pancreatectomy for patients with a history of upper abdominal surgery has been increasing. The clinical courses of 307 patients who underwent the pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) were retrospectively reviewed to clarify the impact of a history of...
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Veröffentlicht in: | The Tohoku Journal of Experimental Medicine 2022, Vol.256(4), pp.337-348 |
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description | Recently, the incidence of pancreatectomy for patients with a history of upper abdominal surgery has been increasing. The clinical courses of 307 patients who underwent the pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) were retrospectively reviewed to clarify the impact of a history of gastrectomy in patients undergoing a pancreatectomy for PDAC. Among 307 patients, 28 (9.1%) had a history of gastrectomy, while 279 did not. We compared the difference in clinical course and prognostic outcomes between the groups. In patients with a history of gastrectomy, the 5-year survival rate was 17.6%, which was relatively poorer than that of patients without it (33.4%, P = 0.1329). A multivariate analysis of factors associated with the overall survival rate identified the low preoperative body mass index [BMI < 20.3 kg/m2, hazard ratio (HR) 1.646, P = 0.0190] and adjuvant chemotherapy (not-completed, HR 1.652, P = 0.0170) as independent prognostic factors. In patients with a history of gastrectomy, there were significantly more patients with poor prognostic factors, including a low preoperative BMI (P = 0.0009) and low completion rate of adjuvant chemotherapy (P = 0.0294) as compared with those without a history of gastrectomy. A low preoperative BMI significantly reduced the completion rate of adjuvant chemotherapy (P = 0.0186), which may lead to poor prognostic outcomes. In conclusion, perioperative nutritional management is important to reduce postoperative BMI loss and obtain a better prognosis after a pancreatectomy for PDAC in patients with a history of gastrectomy. |
doi_str_mv | 10.1620/tjem.2022.J009 |
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The clinical courses of 307 patients who underwent the pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) were retrospectively reviewed to clarify the impact of a history of gastrectomy in patients undergoing a pancreatectomy for PDAC. Among 307 patients, 28 (9.1%) had a history of gastrectomy, while 279 did not. We compared the difference in clinical course and prognostic outcomes between the groups. In patients with a history of gastrectomy, the 5-year survival rate was 17.6%, which was relatively poorer than that of patients without it (33.4%, P = 0.1329). A multivariate analysis of factors associated with the overall survival rate identified the low preoperative body mass index [BMI < 20.3 kg/m2, hazard ratio (HR) 1.646, P = 0.0190] and adjuvant chemotherapy (not-completed, HR 1.652, P = 0.0170) as independent prognostic factors. In patients with a history of gastrectomy, there were significantly more patients with poor prognostic factors, including a low preoperative BMI (P = 0.0009) and low completion rate of adjuvant chemotherapy (P = 0.0294) as compared with those without a history of gastrectomy. A low preoperative BMI significantly reduced the completion rate of adjuvant chemotherapy (P = 0.0186), which may lead to poor prognostic outcomes. In conclusion, perioperative nutritional management is important to reduce postoperative BMI loss and obtain a better prognosis after a pancreatectomy for PDAC in patients with a history of gastrectomy.</description><identifier>ISSN: 0040-8727</identifier><identifier>EISSN: 1349-3329</identifier><identifier>DOI: 10.1620/tjem.2022.J009</identifier><identifier>PMID: 35321979</identifier><language>eng</language><publisher>Japan: Tohoku University Medical Press</publisher><subject>a history of gastrectomy ; body mass index ; Carcinoma, Pancreatic Ductal - pathology ; Carcinoma, Pancreatic Ductal - surgery ; Gastrectomy ; Humans ; Pancreatectomy ; pancreatic ductal adenocarcinoma ; Pancreatic Neoplasms ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - surgery ; Retrospective Studies</subject><ispartof>The Tohoku Journal of Experimental Medicine, 2022, Vol.256(4), pp.337-348</ispartof><rights>2022 Tohoku University Medical Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c373t-a1d22634f4c8cc850d682f29334715ac301d833eea1420b6cdcfd9a72d8804163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35321979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amikura, Katsumi</creatorcontrib><creatorcontrib>Ogura, Toshiro</creatorcontrib><creatorcontrib>Takahashi, Amane</creatorcontrib><title>Strategy of Pancreatectomies for Pancreatic Ductal Adenocarcinoma in Patients with a History of Gastrectomy</title><title>The Tohoku Journal of Experimental Medicine</title><addtitle>Tohoku J. Exp. Med.</addtitle><description>Recently, the incidence of pancreatectomy for patients with a history of upper abdominal surgery has been increasing. The clinical courses of 307 patients who underwent the pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) were retrospectively reviewed to clarify the impact of a history of gastrectomy in patients undergoing a pancreatectomy for PDAC. Among 307 patients, 28 (9.1%) had a history of gastrectomy, while 279 did not. We compared the difference in clinical course and prognostic outcomes between the groups. In patients with a history of gastrectomy, the 5-year survival rate was 17.6%, which was relatively poorer than that of patients without it (33.4%, P = 0.1329). A multivariate analysis of factors associated with the overall survival rate identified the low preoperative body mass index [BMI < 20.3 kg/m2, hazard ratio (HR) 1.646, P = 0.0190] and adjuvant chemotherapy (not-completed, HR 1.652, P = 0.0170) as independent prognostic factors. In patients with a history of gastrectomy, there were significantly more patients with poor prognostic factors, including a low preoperative BMI (P = 0.0009) and low completion rate of adjuvant chemotherapy (P = 0.0294) as compared with those without a history of gastrectomy. A low preoperative BMI significantly reduced the completion rate of adjuvant chemotherapy (P = 0.0186), which may lead to poor prognostic outcomes. In conclusion, perioperative nutritional management is important to reduce postoperative BMI loss and obtain a better prognosis after a pancreatectomy for PDAC in patients with a history of gastrectomy.</description><subject>a history of gastrectomy</subject><subject>body mass index</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Gastrectomy</subject><subject>Humans</subject><subject>Pancreatectomy</subject><subject>pancreatic ductal adenocarcinoma</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Retrospective Studies</subject><issn>0040-8727</issn><issn>1349-3329</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kLlOxDAQQC0EguVoKZFLmiy-kjglApZDSCABtTU4E_CSxGB7hfbvyR6k8cijN694hJxyNuWFYBdpjt1UMCGmD4xVO2TCpaoyKUW1SyaMKZbpUpQH5DDGOWNSsbLYJwcyl4JXZTUhXy8pQMKPJfUNfYbeBhy-NvnOYaSND-PSWXq9sAlaellj7y0E63rfAXX9wCSHfYr016VPCvTOxeTD2nkLMYW1cHlM9hpoI55s5xF5m928Xt1lj0-391eXj5mVpUwZ8FqIQqpGWW2tzlldaNGISkpV8hysZLzWUiICV4K9F7a2TV1BKWqtmeKFPCLnG-938D8LjMl0LlpsW-jRL6IRhRJa56XSAzrdoDb4GAM25ju4DsLScGZWgc0qsFkFNqvAw8HZ1r1477Ae8f-iAzDbAPOY4ANHAMJQsMWtLy-MWr-jeQTsJwSDvfwDEnCQyA</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Amikura, Katsumi</creator><creator>Ogura, Toshiro</creator><creator>Takahashi, Amane</creator><general>Tohoku University Medical Press</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>2022</creationdate><title>Strategy of Pancreatectomies for Pancreatic Ductal Adenocarcinoma in Patients with a History of Gastrectomy</title><author>Amikura, Katsumi ; Ogura, Toshiro ; Takahashi, Amane</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-a1d22634f4c8cc850d682f29334715ac301d833eea1420b6cdcfd9a72d8804163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>a history of gastrectomy</topic><topic>body mass index</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Gastrectomy</topic><topic>Humans</topic><topic>Pancreatectomy</topic><topic>pancreatic ductal adenocarcinoma</topic><topic>Pancreatic Neoplasms</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amikura, Katsumi</creatorcontrib><creatorcontrib>Ogura, Toshiro</creatorcontrib><creatorcontrib>Takahashi, Amane</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>The Tohoku Journal of Experimental Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amikura, Katsumi</au><au>Ogura, Toshiro</au><au>Takahashi, Amane</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Strategy of Pancreatectomies for Pancreatic Ductal Adenocarcinoma in Patients with a History of Gastrectomy</atitle><jtitle>The Tohoku Journal of Experimental Medicine</jtitle><addtitle>Tohoku J. Exp. Med.</addtitle><date>2022</date><risdate>2022</risdate><volume>256</volume><issue>4</issue><spage>337</spage><epage>348</epage><pages>337-348</pages><artnum>2022.J009</artnum><issn>0040-8727</issn><eissn>1349-3329</eissn><abstract>Recently, the incidence of pancreatectomy for patients with a history of upper abdominal surgery has been increasing. The clinical courses of 307 patients who underwent the pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) were retrospectively reviewed to clarify the impact of a history of gastrectomy in patients undergoing a pancreatectomy for PDAC. Among 307 patients, 28 (9.1%) had a history of gastrectomy, while 279 did not. We compared the difference in clinical course and prognostic outcomes between the groups. In patients with a history of gastrectomy, the 5-year survival rate was 17.6%, which was relatively poorer than that of patients without it (33.4%, P = 0.1329). A multivariate analysis of factors associated with the overall survival rate identified the low preoperative body mass index [BMI < 20.3 kg/m2, hazard ratio (HR) 1.646, P = 0.0190] and adjuvant chemotherapy (not-completed, HR 1.652, P = 0.0170) as independent prognostic factors. In patients with a history of gastrectomy, there were significantly more patients with poor prognostic factors, including a low preoperative BMI (P = 0.0009) and low completion rate of adjuvant chemotherapy (P = 0.0294) as compared with those without a history of gastrectomy. A low preoperative BMI significantly reduced the completion rate of adjuvant chemotherapy (P = 0.0186), which may lead to poor prognostic outcomes. In conclusion, perioperative nutritional management is important to reduce postoperative BMI loss and obtain a better prognosis after a pancreatectomy for PDAC in patients with a history of gastrectomy.</abstract><cop>Japan</cop><pub>Tohoku University Medical Press</pub><pmid>35321979</pmid><doi>10.1620/tjem.2022.J009</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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subjects | a history of gastrectomy body mass index Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - surgery Gastrectomy Humans Pancreatectomy pancreatic ductal adenocarcinoma Pancreatic Neoplasms Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Retrospective Studies |
title | Strategy of Pancreatectomies for Pancreatic Ductal Adenocarcinoma in Patients with a History of Gastrectomy |
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