PMID- 27846142
DCOM- 20180306
LR  - 20180405
IS  - 1536-4828 (Electronic)
IS  - 0885-3177 (Linking)
VI  - 46
IP  - 2
DP  - 2017 Feb
TI  - Predictors of Early Mortality After Surgical Resection of Pancreatic
      Adenocarcinoma in the Era of Neoadjuvant Treatment.
PG  - 183-189
LID - 10.1097/MPA.0000000000000731 [doi]
AB  - OBJECTIVES: Neoadjuvant treatments are increasingly used for patients with
      pancreatic ductal adenocarcinoma (PDAC), yet some experience early mortality
      after resection. We sought to identify predictors of early mortality after PDAC
      resection and determine their interaction with neoadjuvant therapy. METHODS: We
      performed a retrospective study of patients with PDAC resection from March 2011
      to March 2014. We compared those who died within one year after surgery to those 
      living beyond 1 year, and those who received neoadjuvant therapy to those taken
      directly to surgery. We used logistic regression to identify predictors of early 
      mortality and determine their interaction with neoadjuvant therapy. RESULTS: Of
      191 patients who underwent resection, 59 (30.9%) died within 1 year and 79
      (41.4%) received neoadjuvant therapy. Early mortality patients were older, with
      higher comorbidity, and more likely to have lymph node positivity. Patients
      receiving neoadjuvant therapy were younger, with lower comorbidity, and more
      likely to have upfront unresectable disease. Predictors of early mortality
      included: higher comorbidity, poorly differentiated tumor grade, and lymph node
      positivity. We found that neoadjuvant therapy moderated the effects of
      comorbidity and lymph node positivity on early mortality risk. CONCLUSIONS: We
      identified predictors of early mortality after PDAC resection and determined
      their interaction with neoadjuvant therapy.
FAU - Nipp, Ryan D
AU  - Nipp RD
AD  - From the Departments of *Medical Oncology, daggerSurgery, double
      daggerBiostatistics Center, and section signDepartment of Radiation Oncology,
      Massachusetts General Hospital, Harvard Medical School, Boston, MA.
FAU - Zanconato, Andrea
AU  - Zanconato A
FAU - Zheng, Hui
AU  - Zheng H
FAU - Ferrone, Cristina R
AU  - Ferrone CR
FAU - Lillemoe, Keith D
AU  - Lillemoe KD
FAU - Wo, Jennifer Y
AU  - Wo JY
FAU - Hong, Theodore S
AU  - Hong TS
FAU - Clark, Jeffrey W
AU  - Clark JW
FAU - Ryan, David P
AU  - Ryan DP
FAU - Fernandez-Del Castillo, Carlos
AU  - Fernandez-Del Castillo C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pancreas
JT  - Pancreas
JID - 8608542
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Pancreatic Ductal/mortality/*therapy
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Pancreatectomy/*methods
MH  - Pancreatic Neoplasms/mortality/*therapy
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Rate
EDAT- 2016/11/16 06:00
MHDA- 2018/03/07 06:00
CRDT- 2016/11/16 06:00
PHST- 2016/11/16 06:00 [pubmed]
PHST- 2018/03/07 06:00 [medline]
PHST- 2016/11/16 06:00 [entrez]
AID - 10.1097/MPA.0000000000000731 [doi]
PST - ppublish
SO  - Pancreas. 2017 Feb;46(2):183-189. doi: 10.1097/MPA.0000000000000731.