2564 resected periampullary adenocarcinomas at a single institution: Trends over three decades

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Abstract

Objective This study was carried out to determine relative survival rates and trends in outcomes in patients who underwent resection of periampullary adenocarcinomas (PACs) with curative intent at a single institution over the last three decades. Methods From 1980 to 2011, 2564 pancreaticoduodenectomies (PDs) were performed for PACs. Pathological diagnosis, therapy and survival were retrospectively analysed. Results The primary sites included the pancreas (66%), ampulla (16%), bile duct (12%) and duodenum (6%). Operation volume increased from 11 per year in the 1980s to 135 per year in the 2000s (P <0.001). Patients in the 1980s were younger (median age: 64 years; range: 33-90 years) than those in the 1990s (median age: 68 years; range: 31-103 years) and 2000s (median age: 68 years; range: 24-93 years) (P <0.001). Over time, the frequency of a diagnosis of pancreatic cancer arising from intraductal papillary mucinous neoplasm increased from 2% in the 1980s to 8% in the 2000s (P <0.001). The rate of 30-day mortality after surgery in the 1980s was 2%, which was similar to rates in the 1990s (1%) and 2000s (1%). Survival in each type of PAC did not change over time. Pancreatic cancer was associated with the worst survival (median survival: 19 months) compared with adenocarcinomas of the ampulla (median survival: 47 months), bile duct (median survival: 23 months) and duodenum (median survival: 54 months) (P <0.001). Conclusions There are significant differences among PACs in longterm survival following PD. Although the numbers of patients undergoing safe resection have increased, overall longterm outcomes have not improved significantly.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalHPB
Volume16
Issue number1
DOIs
StatePublished - Jan 2014

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Adenocarcinoma
Survival
Pancreaticoduodenectomy
Bile Ducts
Pancreatic Neoplasms
Duodenum
Pancreas
Survival Rate
Mortality
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

@article{3d55de589af6424bbe542f96a09e44be,
title = "2564 resected periampullary adenocarcinomas at a single institution: Trends over three decades",
abstract = "Objective This study was carried out to determine relative survival rates and trends in outcomes in patients who underwent resection of periampullary adenocarcinomas (PACs) with curative intent at a single institution over the last three decades. Methods From 1980 to 2011, 2564 pancreaticoduodenectomies (PDs) were performed for PACs. Pathological diagnosis, therapy and survival were retrospectively analysed. Results The primary sites included the pancreas (66{\%}), ampulla (16{\%}), bile duct (12{\%}) and duodenum (6{\%}). Operation volume increased from 11 per year in the 1980s to 135 per year in the 2000s (P <0.001). Patients in the 1980s were younger (median age: 64 years; range: 33-90 years) than those in the 1990s (median age: 68 years; range: 31-103 years) and 2000s (median age: 68 years; range: 24-93 years) (P <0.001). Over time, the frequency of a diagnosis of pancreatic cancer arising from intraductal papillary mucinous neoplasm increased from 2{\%} in the 1980s to 8{\%} in the 2000s (P <0.001). The rate of 30-day mortality after surgery in the 1980s was 2{\%}, which was similar to rates in the 1990s (1{\%}) and 2000s (1{\%}). Survival in each type of PAC did not change over time. Pancreatic cancer was associated with the worst survival (median survival: 19 months) compared with adenocarcinomas of the ampulla (median survival: 47 months), bile duct (median survival: 23 months) and duodenum (median survival: 54 months) (P <0.001). Conclusions There are significant differences among PACs in longterm survival following PD. Although the numbers of patients undergoing safe resection have increased, overall longterm outcomes have not improved significantly.",
author = "Jin He and Nita Ahuja and Makary, {Martin A} and Cameron, {John L} and Frederic Eckhauser and Choti, {Michael A.} and Hruban, {Ralph H} and Pawlik, {Timothy M.} and Christopher Wolfgang",
year = "2014",
month = "1",
doi = "10.1111/hpb.12078",
language = "English (US)",
volume = "16",
pages = "83--90",
journal = "HPB",
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TY - JOUR

T1 - 2564 resected periampullary adenocarcinomas at a single institution

T2 - Trends over three decades

AU - He, Jin

AU - Ahuja, Nita

AU - Makary, Martin A

AU - Cameron, John L

AU - Eckhauser, Frederic

AU - Choti, Michael A.

AU - Hruban, Ralph H

AU - Pawlik, Timothy M.

AU - Wolfgang, Christopher

PY - 2014/1

Y1 - 2014/1

N2 - Objective This study was carried out to determine relative survival rates and trends in outcomes in patients who underwent resection of periampullary adenocarcinomas (PACs) with curative intent at a single institution over the last three decades. Methods From 1980 to 2011, 2564 pancreaticoduodenectomies (PDs) were performed for PACs. Pathological diagnosis, therapy and survival were retrospectively analysed. Results The primary sites included the pancreas (66%), ampulla (16%), bile duct (12%) and duodenum (6%). Operation volume increased from 11 per year in the 1980s to 135 per year in the 2000s (P <0.001). Patients in the 1980s were younger (median age: 64 years; range: 33-90 years) than those in the 1990s (median age: 68 years; range: 31-103 years) and 2000s (median age: 68 years; range: 24-93 years) (P <0.001). Over time, the frequency of a diagnosis of pancreatic cancer arising from intraductal papillary mucinous neoplasm increased from 2% in the 1980s to 8% in the 2000s (P <0.001). The rate of 30-day mortality after surgery in the 1980s was 2%, which was similar to rates in the 1990s (1%) and 2000s (1%). Survival in each type of PAC did not change over time. Pancreatic cancer was associated with the worst survival (median survival: 19 months) compared with adenocarcinomas of the ampulla (median survival: 47 months), bile duct (median survival: 23 months) and duodenum (median survival: 54 months) (P <0.001). Conclusions There are significant differences among PACs in longterm survival following PD. Although the numbers of patients undergoing safe resection have increased, overall longterm outcomes have not improved significantly.

AB - Objective This study was carried out to determine relative survival rates and trends in outcomes in patients who underwent resection of periampullary adenocarcinomas (PACs) with curative intent at a single institution over the last three decades. Methods From 1980 to 2011, 2564 pancreaticoduodenectomies (PDs) were performed for PACs. Pathological diagnosis, therapy and survival were retrospectively analysed. Results The primary sites included the pancreas (66%), ampulla (16%), bile duct (12%) and duodenum (6%). Operation volume increased from 11 per year in the 1980s to 135 per year in the 2000s (P <0.001). Patients in the 1980s were younger (median age: 64 years; range: 33-90 years) than those in the 1990s (median age: 68 years; range: 31-103 years) and 2000s (median age: 68 years; range: 24-93 years) (P <0.001). Over time, the frequency of a diagnosis of pancreatic cancer arising from intraductal papillary mucinous neoplasm increased from 2% in the 1980s to 8% in the 2000s (P <0.001). The rate of 30-day mortality after surgery in the 1980s was 2%, which was similar to rates in the 1990s (1%) and 2000s (1%). Survival in each type of PAC did not change over time. Pancreatic cancer was associated with the worst survival (median survival: 19 months) compared with adenocarcinomas of the ampulla (median survival: 47 months), bile duct (median survival: 23 months) and duodenum (median survival: 54 months) (P <0.001). Conclusions There are significant differences among PACs in longterm survival following PD. Although the numbers of patients undergoing safe resection have increased, overall longterm outcomes have not improved significantly.

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U2 - 10.1111/hpb.12078

DO - 10.1111/hpb.12078

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