Surgical Outcomes and Survival in Pancreatic and Periampullary Cancers: A Single Centre Experience.

Abstract

Pancreatic cancer is an aggressive malignancy with many cases diagnosed at locally advanced stages making pancreaticoduodenectomy a technically challenging surgery with significant mortality and morbidity. This study analyses the surgical outcomes and survival after surgery for pancreatic cancers from a single centre in south India. This is a retrospective analysis of pancreatic and periampullary cancer patients who were treated in our institute between January 2014 and November 2022 (n = 71). The median age at diagnosis was 55 years. In about 2/3rd of cases, tumour was located in periampullary region and 62 out of 71 patients underwent curative resection. The most common histopathological diagnosis was adenocarcinoma (87%). Nodal metastasis were detected in 13% of specimens. The predominant morbidity was delayed gastric emptying (DGE 12.7%) and clinically relevant postoperative pancreatic fistula (CR-POPF 11%) with a combined overall morbidity of 35.2% and 30-day mortality of 7.3%. Pre-op nutritional status had a strong association with postoperative morbidity. The median time of survival was 20 months, with a median follow-up of 22 months. Age less than 60 years (P value = 0.0264) and receiving all 6 or more cycles of chemo were significantly associated with improved survival (P value = 0.0297). Lower-stage cancers (T1, T2, and N0) were associated with better survival. The patient characteristics, histological factors, and perioperative outcomes were similar to the reports from other Indian studies. The 3-year survival rate was 30%. There was an increasing trend of survival in patients with age less than 60 years and in patients who received 6 or more cycles of chemotherapy.