TY - JOUR
T1 - Delayed Recovery after Pancreaticoduodenectomy
T2 - A Major Factor Impairing the Delivery of Adjuvant Therapy?
AU - Aloia, Thomas E.
AU - Lee, Jeffrey E.
AU - Vauthey, Jean Nicolas
AU - Abdalla, Eddie K.
AU - Wolff, Robert A.
AU - Varadhachary, Gauri R.
AU - Abbruzzese, James L.
AU - Crane, Christopher H.
AU - Evans, Douglas B.
AU - Pisters, Peter W.T.
N1 - Funding Information:
Supported by the Lockton Fund for Pancreatic Cancer Research and NIH 1 P20 CA101936-01 (SPORE in Pancreatic Cancer). Original scientific article
PY - 2007/3
Y1 - 2007/3
N2 - Background: Delayed recovery after pancreaticoduodenectomy (PD) is believed to preclude adjuvant therapy for approximately 30% of patients who undergo elective PD as initial treatment for pancreatic adenocarcinoma. This study reexamined the frequency of delayed recovery and assessed other factors associated with adjuvant therapy administration after PD at a high-volume center. Study Design: Preoperative and perioperative variables were reviewed in a consecutive series of 85 patients with pancreatic adenocarcinoma undergoing PD without preoperative chemotherapy or radiotherapy from 1990 to 2004. Results: Study groups included patients undergoing emergency PD (group 1, n = 13); elective PD with good preoperative Eastern Cooperative Oncology Group (ECOG) performance status (PS) (group 2, ECOG PS: 0 to 1, n = 63); and elective PD with marginal preoperative PS (group 3, ECOG PS: 2 to 3, n = 9). Delayed recovery of PS precluded adjuvant therapy in 23% of patients in group 1, 6% of patients in group 2, and 44% of patients in group 3 (p = 0.0001). Conclusions: The impact of delayed recovery after PD on the delivery of adjuvant therapy depends on the urgency of surgery and the preoperative PS. For patients with good preoperative PS who undergo elective PD at a high-volume center, it is uncommon for delayed recovery to preclude delivery of adjuvant therapy.
AB - Background: Delayed recovery after pancreaticoduodenectomy (PD) is believed to preclude adjuvant therapy for approximately 30% of patients who undergo elective PD as initial treatment for pancreatic adenocarcinoma. This study reexamined the frequency of delayed recovery and assessed other factors associated with adjuvant therapy administration after PD at a high-volume center. Study Design: Preoperative and perioperative variables were reviewed in a consecutive series of 85 patients with pancreatic adenocarcinoma undergoing PD without preoperative chemotherapy or radiotherapy from 1990 to 2004. Results: Study groups included patients undergoing emergency PD (group 1, n = 13); elective PD with good preoperative Eastern Cooperative Oncology Group (ECOG) performance status (PS) (group 2, ECOG PS: 0 to 1, n = 63); and elective PD with marginal preoperative PS (group 3, ECOG PS: 2 to 3, n = 9). Delayed recovery of PS precluded adjuvant therapy in 23% of patients in group 1, 6% of patients in group 2, and 44% of patients in group 3 (p = 0.0001). Conclusions: The impact of delayed recovery after PD on the delivery of adjuvant therapy depends on the urgency of surgery and the preoperative PS. For patients with good preoperative PS who undergo elective PD at a high-volume center, it is uncommon for delayed recovery to preclude delivery of adjuvant therapy.
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U2 - 10.1016/j.jamcollsurg.2006.12.011
DO - 10.1016/j.jamcollsurg.2006.12.011
M3 - Article
C2 - 17324767
AN - SCOPUS:33847117592
SN - 1072-7515
VL - 204
SP - 347
EP - 355
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 3
ER -