• Gareth Eeson, Nicolas Chang, Colleen E McGahan, Fareeza Khurshed, Andrzej K Buczkowski, Charles H Scudamore, Garth L Warnock, and Stephen W Chung.
• Department of Surgery, University of British Columbia, and the BC Cancer Agency, Department of Cancer Surveillance & Outcomes, Surgical Oncology Network, 2775 Laurel Street, Vancouver, BC, Canada.
• HPB (Oxford). 2012 May 1;14(5):310-6.

IntroductionA pancreaticoduodenectomy is the reference treatment for a resectable pancreatic head ductal adenocarcinoma. The probability of 5-year survival in patients undergoing such treatment is 5-25% and is associated with relatively high peri-operative morbidity and mortality. The objective of the present study was to evaluate risk factors predictive of outcome for patients undergoing a pancreaticoduodenectomy for a pancreatic adenocarcinoma.MethodsThis retrospective analysis incorporated data from the Vancouver General Hospital and the British Columbia Cancer Agency (BCCA) from 1999-2007.ResultsThe 5-year survival of 100 patients was 12% with a median survival of 16.5 months. Ninety-day mortality was 7%. Predictors of 90-day mortality included age ≥ 80 years (P < 0.001) and an American Society of Anesthesiologists (ASA) score = 3 (P= 0.012) by univariate analysis and age ≥80 years (P < 0.001) by multivariate analysis. The identifiable predictive factor for poor 5-year survival was an ASA score = 3 (P= 0.043) whereas a Dindo-Clavien surgical complication grade ≥ 3 was associated with a worse outcome (P= 0.013). Referral to the BCCA was associated with a favourable 5-year survival (P= 0.001).Conclusions  The present study identifies risk factors for patient selection to enhance survival benefit in this patient population.© 2012 International Hepato-Pancreato-Biliary Association.

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