Preoperative Characteristics of Patients with Presumed Pancreatic Cancer but Ultimately Benign Disease: A Multicenter Series of 344 Pancreatoduodenectomies

Arja Gerritsen, I. Quintus Molenaar, Thomas L. Bollen, C. Yung Nio, Marcel G. Dijkgraaf, Hjalmar C. van Santvoort, G. Johan Offerhaus, Lodewijk A. Brosens, Katharina Biermann, Egbert Sieders, Koert P. de Jong, Ronald M. van Dam, Erwin van der Harst, Harry van Goor, Bert van Ramshorst, Bert A. Bonsing, Ignace H. de Hingh, Michael F. Gerhards, Casper H. van Eijck, Dirk J. GoumaInne H M Borel Rinkes, Olivier R C Busch, Marc G. Besselink

Research output: Contribution to journalArticle

Abstract

Background: Preoperative differentiation between malignant and benign pancreatic tumors can be difficult. Consequently, a proportion of patients undergoing pancreatoduodenectomy for suspected malignancy will ultimately have benign disease. The aim of this study was to compare preoperative clinical and diagnostic characteristics of patients with unexpected benign disease after pancreatoduodenectomy with those of patients with confirmed (pre)malignant disease.

Methods: We performed a multicenter retrospective cohort study in 1,629 consecutive patients undergoing pancreatoduodenectomy for suspected malignancy between 2003 and 2010 in 11 Dutch centers. Preoperative characteristics were compared in a benign:malignant ratio of 1:3. Malignant cases were selected from the entire cohort by using a random number list. A multivariable logistic regression prediction model was constructed to predict benign disease.

Results: Of 107 patients (6.6 %) with unexpected benign disease after pancreatoduodenectomy, 86 fulfilled the inclusion criteria and were compared with 258 patients with (pre)malignant disease. Patients with benign disease presented more often with pain (56 vs. 38 %; P = 0.004), but less frequently with jaundice (60 vs. 80 %; P 

Conclusions: Nearly 7 % of patients undergoing pancreatoduodenectomy for suspected malignancy were ultimately diagnosed with benign disease. Although some preoperative clinical and imaging characteristics might indicate absence of malignancy, their discriminatory value is insufficient for clinical use.

Original languageEnglish (US)
Pages (from-to)3999-4006
Number of pages8
JournalAnnals of Surgical Oncology
Volume21
Issue number12
DOIs
Publication statusPublished - Oct 8 2014
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

Cite this

Gerritsen, A., Molenaar, I. Q., Bollen, T. L., Nio, C. Y., Dijkgraaf, M. G., van Santvoort, H. C., ... Besselink, M. G. (2014). Preoperative Characteristics of Patients with Presumed Pancreatic Cancer but Ultimately Benign Disease: A Multicenter Series of 344 Pancreatoduodenectomies. Annals of Surgical Oncology, 21(12), 3999-4006. https://doi.org/10.1245/s10434-014-3810-7