Chemotherapy and radiation components of neoadjuvant treatment of pancreatic head adenocarcinoma: Impact on perioperative mortality and long-term survival

2017 ◽  
Vol 43 (2) ◽  
pp. 351-357 ◽  
Author(s):  
J. Franko ◽  
H.W. Hsu ◽  
P. Thirunavukarasu ◽  
D. Frankova ◽  
C.D. Goldman
Keyword(s):  
Neoadjuvant Treatment ◽  
Pancreatic Head ◽  
Perioperative Mortality ◽  
Term Survival ◽  
Long Term Survival

The Long-Term Survival of Patients with Ductal Carcinoma of the Pancreatic Head and Body

1997 ◽  
pp. 143-150
Author(s):  
Hisashi Mimura ◽  
Masanobu Mori ◽  
Takuji Mimura ◽  
Keisuke Hamazaki ◽  
Hiromu Tsuge
Keyword(s):  
Ductal Carcinoma ◽  
Pancreatic Head ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Current State of Vascular Resections in Pancreatic Cancer Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Thilo Hackert ◽  
Lutz Schneider ◽  
Markus W. Büchler
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Treatment ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Treatment Strategies ◽  
Western World ◽  
Term Survival ◽  
Long Term Survival ◽  
Current State

Pancreatic cancer (PDAC) is the fourth leading cause of cancer-related mortality in the Western world and, even in 2014, a therapeutic challenge. The only chance for long-term survival is radical surgical resection followed by adjuvant chemotherapy which can be performed in about 20% of all PDAC patients by the time of diagnosis. As pancreatic surgery has significantly changed during the past years, extended operations, including vascular resections, have become more frequently performed in specialized centres and the border of resectability has been pushed forward to achieve a potentially curative approach in the respective patients in combination with neoadjuvant and adjuvant treatment strategies. In contrast to adjuvant treatment which has to be regarded as a cornerstone to achieve long-term survival after resection, neoadjuvant treatment strategies for locally advanced findings are currently under debate. This overview summarizes the possibilities and evidence of vascular, namely, venous and arterial, resections in PDAC surgery.

scholarly journals P3.16-046 Pneumonectomy After Induction/Neoadjuvant Treatment for NSCLC: Morbidity, Mortality and Long-Term Survival

2017 ◽  
Vol 12 (11) ◽  
pp. S2360
Author(s):  
C. Gebitekin ◽  
A. Toker ◽  
W. Weder ◽  
H. Melek ◽  
B. Özkan ◽  
...  
Keyword(s):  
Neoadjuvant Treatment ◽  
Term Survival ◽  
Long Term Survival

Does preoperative biliary drainage compromise the long-term survival of patients with pancreatic head carcinoma?

2014 ◽  
Vol 111 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Yoshiaki Murakami ◽  
Kenichiro Uemura ◽  
Yasushi Hashimoto ◽  
Naru Kondo ◽  
Naoya Nakagawa ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Pancreatic Head ◽  
Preoperative Biliary Drainage ◽  
Term Survival ◽  
Long Term Survival ◽  
Pancreatic Head Carcinoma

Directing Surgical Quality Improvement Initiatives: Comparison of Perioperative Mortality and Long-Term Survival for Cancer Surgery

2008 ◽  
Vol 26 (28) ◽  
pp. 4626-4633 ◽  
Author(s):  
Karl Y. Bilimoria ◽  
David J. Bentrem ◽  
Joseph M. Feinglass ◽  
Andrew K. Stewart ◽  
David P. Winchester ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Conditional Survival ◽  
Surgical Volume ◽  
Perioperative Mortality ◽  
Quality Initiatives ◽  
Term Survival ◽  
Long Term Survival ◽  
Hazard Ratios ◽  
Low Volume

Purpose Quality-improvement initiatives are being developed to decrease volume-based variability in surgical outcomes. Resources for national and hospital quality-improvement initiatives are limited. It is unclear whether quality initiatives in surgical oncology should focus on factors affecting perioperative mortality or long-term survival. Our objective was to determine whether differences in hospital surgical volume have a larger effect on perioperative mortality or long-term survival using two methods. Patients and Methods From the National Cancer Data Base, 243,103 patients who underwent surgery for nonmetastatic colon, esophageal, gastric, liver, lung, pancreatic, or rectal cancer were identified. Multivariable modeling was used to evaluate 60-day mortality and 5-year conditional survival (excluding perioperative deaths) across hospital volume strata. The number of potentially avoidable perioperative and long-term deaths were calculated if outcomes at low-volume hospitals were improved to those of the highest-volume hospitals. Results Risk-adjusted perioperative mortality and long-term conditional survival worsened as hospital surgical volume decreased for all cancer sites, except for liver resections where there was no difference in survival. When comparing low- with high-volume hospitals, the hazard ratios for perioperative mortality were substantially larger than for long-term survival. However, the number of potentially avoidable deaths each year in the United States, if outcomes at low-volume hospitals were improved to the level of highest-volume centers, was significantly larger for long-term survival. Conclusion Although the magnitude of the hazard ratios implies that quality-improvement efforts should focus on perioperative mortality, a larger number of deaths could be avoided by focusing quality initiatives on factors associated with long-term survival.

Incidence and causes of perioperative mortality after primary surgery for intracranial tumors: a national, population-based study

2012 ◽  
Vol 116 (4) ◽  
pp. 825-834 ◽  
Author(s):  
Ole Solheim ◽  
Asgeir Store Jakola ◽  
Sasha Gulati ◽  
Tom Børge Johannesen
Keyword(s):  
Quality Indicator ◽  
Mortality Rates ◽  
Population Based ◽  
Intracranial Tumor ◽  
Surgical Mortality ◽  
Intracranial Tumors ◽  
Perioperative Mortality ◽  
Term Survival ◽  
Long Term Survival

Object Surgical mortality is a frequent outcome measure in studies of volume-outcome relationships, and the Agency for Healthcare Research and Quality has endorsed surgical mortality after craniotomies as an Inpatient Quality Indicator. Still, the frequency and causes of 30-day mortality after neurosurgical procedures have not been much explored. The authors sought to study the frequency and possible causes of death following primary intracranial tumor operations. They also sought to explore a possible predictive value of perioperative mortality rates from neurosurgical centers in relation to long-term survival. Methods Using population-based data from the Norwegian cancer registry, the authors identified 15,918 primary operations for primary CNS tumors treated in Norway in the period from August 1955 through December 2008. Patients were followed up until death, emigration, or September 2009. Causes of mortality as indicated on death certificates were studied. Factors associated with an increased risk of perioperative death were identified. Results The overall risk of perioperative death after first-time surgery for primary intracranial tumors is currently 2.2% and has decreased over the last decades. An age ≥ 70 years and histopathological entities with poor long-term prognoses are risk factors. Overlapping lesions are also associated with excess risk, indicating that lesion size or multifocality may matter. The overall risk of perioperative death is also higher in biopsy cases than in resection cases. Perioperative mortality rates of the 4 Norwegian neurosurgical centers were not predictive of their respective long-term survival rates. Conclusions Although considered surgically related if they occur within the first 30 days of surgery, most early postoperative deaths can happen independent of the handiwork of the operating surgeon or anesthesiologist. Overall prognosis of the disease seems to be a strong predictor of perioperative death—perhaps not surprisingly since the 30-day mortality rate is merely the intonation of the Kaplan-Meier curve. Both referral and treatment policies at a neurosurgical center will therefore markedly affect such early outcomes, but early deaths may not necessarily reflect overall quality of care or long-term results. The low incidence of perioperative death in intracranial tumor surgery also greatly limits the statistical power in comparative analyses, such as between published patient series or between centers and certainly between surgeons. Therefore the authors question the value of perioperative mortality rates as a quality indicator in modern neurosurgery for tumors.

Sign in / Sign up

Export Citation Format

Share Document