Preoperative prognostic factors associated with early mortality after upfront pancreatoduodenectomy for Pancreatic Adenocarcinoma

• Introduction: Tumour related factors are well known as risk factors for survival after pancreatoduodenectomy (PD). In a time when the role for neoadjuvant treatment is discussed also in primary resectable patients, the influence of preoperative variables is of interest. The aim was to examine preoperative factors influence on early mortality following PD.Materials: Patients registered in the Swedish National Registry for Pancreatic and Periampullary Cancer that underwent PD from January 2010 until October 2017, with pancreatic ductal adenocarcinoma and a follow-up of at least 12 months, were included. Univariable and multivariable logistic regression analysis was performed to evaluate preoperatively registered predictors of early death (within 12 months).Results: In total 2,183 pancreatoduodenectomies were performed and 988 patients met the study criteria. The mean age was 67.8 years and 48% were female. A majority had weight loss (59%) and preoperative biliary drainage (78%). 241 (24%) died within 12 months. In univariable analysis age>75 years (p=0.011), CRP>10 mg/L (p=0.008), diabetes (p=0.033), respiratory disorders (p=0.001), and ASA-score >2 (p>0.001) were prognostic factors for early death. In multivariable analysis age>75 years (OR1.66, CI 1.16–2.37, p=0.006), CRP>10 mg/L (OR 1.51, CI 1.10–2.07, p=0.001), diabetes (OR 1.42, CI 1.01–1.99, p=0.045), and respiratory disorders (OR 2.40 CI 1.38–4.18, p=0.002) were independent factors.Discussion: From a national database older age, elevated CRP, diabetes, and respiratory disorders were identified as independent preoperative risk factors for early mortality following PD. This findings may be used in an individualised treatment plan.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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