Nationwide analysis of one-year mortality following pancreatectomy in 17,183 patients with pancreatic cancer

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-01-01 DOI:10.1016/j.hpb.2024.10.011

Ugo Marchese , Xavier Lenne , Gaanan Naveendran , Stylianos Tzedakis , Martin Gaillard , Yasmina Richa , Laurent Boyer , Didier Theis , Amelie Bruandet , Stephanie Truant , David Fuks , Mehdi EL Amrani

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引用次数: 0

Abstract

Background

The use of 1-year mortality following pancreatectomy for PDAC as a measure of surgical quality has not been evaluated. We aim to i) assess the 1-year mortality rate following pancreatectomy for PDAC, and ii) identify patient and hospital characteristics associated with 1-year mortality.

Methods

Data was extracted retrospectively from the French national medico-administrative database. The study included patients who underwent pancreatectomy for PDAC between January 2012 and December 2019. The primary outcome was 1-year postoperative mortality. Hospitals were classified based on volume (high (≥26 resections/year) and low volume (<26)).

Results

Overall, 17,183 patients who underwent pancreatectomy for PDAC were included. The overall 90-day and 1-year mortalities were 6.5 % and 21.5 %, respectively. 1-year mortality varied significantly between low and high-volume hospitals (23.6 % vs. 18.6 %, respectively, p < 0.001). Older age, Charlson Comorbidity Index (CCI), readmission, major complications were predictive factors for 1-year mortality. Pancreatectomy in low volume hospitals increased the risk of 1-year mortality by 1.23-fold (OR = 1.23, 95 % CI [1.15–1.32], p < 0.001).

Conclusion

The overall 1-year mortality after pancreatectomy for PDAC was 21.5 %, and was higher in patients of older age, with higher comorbidities, who experienced major complications, and who did not receive adjuvant therapy. Management in high-volume centers decreased mortality rates, regardless of the patient’s condition.

查看原文本刊更多论文

对 17,183 名胰腺癌患者进行胰腺切除术后一年死亡率的全国性分析。

背景：将 PDAC 胰腺切除术后 1 年死亡率作为手术质量的衡量标准尚未进行评估。我们的目的是：i）评估 PDAC 胰腺切除术后 1 年的死亡率；ii）确定与 1 年死亡率相关的患者和医院特征：方法：从法国国家医疗行政数据库中回顾性提取数据。研究对象包括2012年1月至2019年12月期间因PDAC接受胰腺切除术的患者。主要结果是术后1年死亡率。根据医院的手术量（高手术量（≥26例切除术/年）和低手术量（结果：共纳入17183名因PDAC接受胰腺切除术的患者。90天和1年总死亡率分别为6.5%和21.5%。低流量医院和高流量医院的 1 年死亡率差异很大（分别为 23.6% 和 18.6%，P 结语）：PDAC胰腺切除术后1年总死亡率为21.5%，年龄较大、合并症较多、出现主要并发症和未接受辅助治疗的患者死亡率较高。无论患者病情如何，在高流量中心进行治疗都能降低死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).