• June S Peng, Daniel Joyce, Maureen Brady, Adrienne Groman, Kristopher Attwood, Boris Kuvshinoff, Steven N Hochwald, and Moshim Kukar.
• Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
• J Surg Oncol. 2020 Aug 1; 122 (2): 195-203.

Background And ObjectivesPasireotide was shown in a randomized trial to decrease the rate of postoperative pancreatic fistula (POPF). However, retrospective series from other centers have failed to confirm these results.MethodsPatients who underwent pancreatoduodenectomy or distal pancreatectomy between January 2014 and February 2019 were included. Patients treated after November 2016 routinely received pasireotide and were compared to a retrospective cohort. Multivariate analysis was performed for the outcome of clinically relevant POPF (CR-POPF), with stratification by fistula risk score (FRS).ResultsNinety-nine of 300 patients received pasireotide. The distribution of high, intermediate, low, and negligible risk patients by FRS was comparable (P = .487). There were similar rates of CR-POPF (19.2% pasireotide vs 14.9% control, P = .347) and percutaneous drainage (12.1% vs 10.0%, P = .567), with greater median number of drain days in the pasireotide group (6 vs 4 days, P < .001). Multivariate modeling for CR-POPF showed no correlation with operation or pasireotide use. Adjustment with propensity weighted models for high (OR, 1.02, 95% CI, 0.45-2.29) and intermediate (OR, 1.02, CI, 0.57-1.81) risk groups showed no correlation of pasireotide with reduction in CR-POPF.ConclusionsPasireotide administration after pancreatectomy was not associated with a decrease in CR-POPF, even when patients were stratified by FRS.© 2020 Wiley Periodicals LLC.

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