Abstract
Introduction
Patients who suffer a serious complication of pancreatoduodenectomy (PD) may have
their adjuvant chemotherapy (AC) delayed or omitted as a result. We aimed to investigate
whether PD complications affected AC rates.
Materials and methods
A retrospective analysis of all PD patients with histologically-confirmed pancreatic
ductal adenocarcinoma (2006–2015) was performed; 90-day mortality patients were excluded.
Patients who commenced AC were compared to those who did not (morbidity rates and
survival) and patients who developed selected postoperative complications were compared
to those who did not (AC rates and survival).
Results
157 patients were included and 90-day mortality was 3.8%. Of the remaining patients,
102 (68.5%) received AC (AC data unavailable for two patients). Survival was longer
in the AC group (p = 0.004). AC patients had less frequently experienced a postoperative
chest infection (8.82% vs 34.0%, p = 0.0003) or a postoperative complication which
was Clavien-Dindo (CD) grade ≥ II (29.4% vs 57.4%, p = 0.0019) or ≥ III (6.86% vs
21.3%, p = 0.023). Patients who experienced a postoperative chest infection (36.0%
vs 75.0%, p = 0.0003) or a postoperative complication which was CD grade ≥ II (48.9%
vs 73.1%, p = 0.0099) or ≥ III (29.4% vs 70.3%, p = 0.0018) less frequently commenced
AC.
Conclusion
Patients who received AC had less frequently experienced a serious postoperative complication.
Efforts should be made to preoperatively identify those who are high-risk for a serious
complication as this cohort may benefit from neoadjuvant therapy.
Keywords
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Article info
Publication history
Published online: August 30, 2022
Accepted:
August 26,
2022
Received in revised form:
August 10,
2022
Received:
June 6,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd. All rights reserved.
