What are predictors of long-term survival after distal pancreatectomy for pancreatic adenocarcinoma? A single-center experience

Abstract

Background: Few studies have previously explored potential predictors of long-term survival after distal pancreatectomy (DP) for pancreatic adenocarcinoma (PDAC), but reached conflicting Results. Furthermore, it appears that there are some differences of prognostic factors between the pancreatic head and body/ tail cancers. The present study aims to explore potential predictors of survival after DP for PDAC of the body and tail, in a relatively large single-center experience. Material & Methods: Between January 1, 2002, and December 31, 2015, 99 patients underwent DP for PDAC. Uni- and multivariate analyses were performed using the Kaplan-Meier curves with log-rank test and Cox proportional hazards models. Results: The median overall survival time for the entire cohort was 17.5 months. Upper digestive stenosis (HR = 1.762; 95%CI, 1.013 – 3.066; p = 0.045), weight loss (HR = 3.996; 95%CI, 1.055 – 15.127; p = 0.041), vascular resection (HR = 3.152; 95%CI, 1.322 – 7.514; p = 0.010), lymph nodes metastases (HR = 1.778; 95%CI, 1.018 – 3.106; p = 0.043), and positive resection margins (HR = 2.319; 95%CI, 1.296 – 4.151; p = 0.005) were found to be independent risk factors of poor survival. Conclusions: Patients with PDAC and weight loss, upper digestive stenosis at diagnosis, associated vascular resection, positive lymph nodes, and resection margins are expected to have a poor long-term survival after DP.