Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer

Lilly J H Brada; Thijs J Schouten; Lois A Daamen; Leonard W F Seelen; Marieke S Walma; Ronald van Dam; Ignace H de Hingh; Mike S L Liem; Vincent E de Meijer; Gijs A Patijn; Sebastiaan Festen; Martijn W J Stommel; Koop Bosscha; Marc G Besselink; Hjalmar C van Santvoort; Izaak Quintus Molenaar

doi:10.1097/SLA.0000000000006289

Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer

Lilly J H Brada, Thijs J Schouten, Lois A Daamen, Leonard W F Seelen, Marieke S Walma, Ronald van Dam, Ignace H de Hingh, Mike S L Liem, Vincent E de Meijer, Gijs A Patijn, Sebastiaan Festen, Martijn W J Stommel, Koop Bosscha, Marc G Besselink, Hjalmar C van Santvoort, Izaak Quintus Molenaar^*,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: To evaluate short and long-term outcomes after pancreatectomy in patients with locally advanced pancreatic cancer (LAPC) compared with patients with (borderline) resectable pancreatic cancer [(B)RPC]. Background: Selected patients diagnosed with LAPC are increasingly undergoing resection after induction chemotherapy. To evaluate the benefit of this treatment approach, it is helpful to compare outcomes in resected patients with primary LAPC to outcomes in resected patients with primary (B)RPC. Methods: Two prospectively maintained nationwide databases were used for this study. Patients with (B)RPC undergoing upfront tumor resection and patients with resected LAPC after induction therapy were included. Outcomes were postoperative pancreas-specific complications, 90-day mortality, pathologic outcomes, disease-free interval, and overall survival. Results: Overall, 879 patients were included; 103 with LAPC (12%) and 776 with (B)RPC (88%). Patients with LAPC had a lower World Health Organization performance score and ageadjusted Charlson Comorbidity Index. Postoperative pancreas-specific complications were comparable between groups, except delayed gastric emptying grade C, which occurred more often in patients with LAPC (9% vs 3%, P = 0.03). Ninety-day mortality was comparable. About half of the patients in both groups [54% in LAPC vs 48% in (B)RPC, P = 0.21] had a radical resection (R0). Disease-free interval was 13 months in both groups (P = 0.12) and overall survival from the date of diagnosis was 24 months in patients with LAPC and 19 months in patients with (B)RPC (P = 0.34). Conclusions: In our nationwide prospective databases, pancreas-specific complications, mortality, and survival in patients with LAPC after pancreatectomy are comparable with those undergoing resection for (B)RPC. These outcomes suggest that postoperative morbidity and mortality after tumor resection in carefully selected patients with LAPC are acceptable.

Original language	English
Pages (from-to)	1026-1031
Number of pages	6
Journal	Annals of surgery
Volume	281
Issue number	6
Early online date	1 Apr 2024
DOIs	https://doi.org/10.1097/SLA.0000000000006289
Publication status	Published - 1 Jun 2025

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10.1097/SLA.0000000000006289

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Brada, L. J. H., Schouten, T. J., Daamen, L. A., Seelen, L. W. F., Walma, M. S., van Dam, R., de Hingh, I. H., Liem, M. S. L., de Meijer, V. E., Patijn, G. A., Festen, S., Stommel, M. W. J., Bosscha, K., Besselink, M. G., van Santvoort, H. C., Molenaar, I. Q. (2025). Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer. Annals of surgery, 281(6), 1026-1031. https://doi.org/10.1097/SLA.0000000000006289

@article{863cccaf1938418687c0145da17ad4b0,

title = "Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer",

abstract = "Objective: To evaluate short and long-term outcomes after pancreatectomy in patients with locally advanced pancreatic cancer (LAPC) compared with patients with (borderline) resectable pancreatic cancer [(B)RPC]. Background: Selected patients diagnosed with LAPC are increasingly undergoing resection after induction chemotherapy. To evaluate the benefit of this treatment approach, it is helpful to compare outcomes in resected patients with primary LAPC to outcomes in resected patients with primary (B)RPC. Methods: Two prospectively maintained nationwide databases were used for this study. Patients with (B)RPC undergoing upfront tumor resection and patients with resected LAPC after induction therapy were included. Outcomes were postoperative pancreas-specific complications, 90-day mortality, pathologic outcomes, disease-free interval, and overall survival. Results: Overall, 879 patients were included; 103 with LAPC (12%) and 776 with (B)RPC (88%). Patients with LAPC had a lower World Health Organization performance score and ageadjusted Charlson Comorbidity Index. Postoperative pancreas-specific complications were comparable between groups, except delayed gastric emptying grade C, which occurred more often in patients with LAPC (9% vs 3%, P = 0.03). Ninety-day mortality was comparable. About half of the patients in both groups [54% in LAPC vs 48% in (B)RPC, P = 0.21] had a radical resection (R0). Disease-free interval was 13 months in both groups (P = 0.12) and overall survival from the date of diagnosis was 24 months in patients with LAPC and 19 months in patients with (B)RPC (P = 0.34). Conclusions: In our nationwide prospective databases, pancreas-specific complications, mortality, and survival in patients with LAPC after pancreatectomy are comparable with those undergoing resection for (B)RPC. These outcomes suggest that postoperative morbidity and mortality after tumor resection in carefully selected patients with LAPC are acceptable.",

author = "Brada, {Lilly J H} and Schouten, {Thijs J} and Daamen, {Lois A} and Seelen, {Leonard W F} and Walma, {Marieke S} and {van Dam}, Ronald and {de Hingh}, {Ignace H} and Liem, {Mike S L} and {de Meijer}, {Vincent E} and Patijn, {Gijs A} and Sebastiaan Festen and Stommel, {Martijn W J} and Koop Bosscha and Besselink, {Marc G} and {van Santvoort}, {Hjalmar C} and Molenaar, {Izaak Quintus}",

year = "2025",

month = jun,

day = "1",

doi = "10.1097/SLA.0000000000006289",

language = "English",

volume = "281",

pages = "1026--1031",

journal = "Annals of surgery",

issn = "0003-4932",

publisher = "Lippincott Williams & Wilkins",

number = "6",

}

Brada, LJH, Schouten, TJ , Daamen, LA, Seelen, LWF, Walma, MS, van Dam, R, de Hingh, IH, Liem, MSL, de Meijer, VE, Patijn, GA, Festen, S, Stommel, MWJ, Bosscha, K, Besselink, MG, van Santvoort, HC , Molenaar, IQ 2025, 'Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer', Annals of surgery, vol. 281, no. 6, pp. 1026-1031. https://doi.org/10.1097/SLA.0000000000006289

TY - JOUR

T1 - Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer

AU - Brada, Lilly J H

AU - Schouten, Thijs J

AU - Daamen, Lois A

AU - Seelen, Leonard W F

AU - Walma, Marieke S

AU - van Dam, Ronald

AU - de Hingh, Ignace H

AU - Liem, Mike S L

AU - de Meijer, Vincent E

AU - Patijn, Gijs A

AU - Festen, Sebastiaan

AU - Stommel, Martijn W J

AU - Bosscha, Koop

AU - Besselink, Marc G

AU - van Santvoort, Hjalmar C

AU - Molenaar, Izaak Quintus

PY - 2025/6/1

Y1 - 2025/6/1

N2 - Objective: To evaluate short and long-term outcomes after pancreatectomy in patients with locally advanced pancreatic cancer (LAPC) compared with patients with (borderline) resectable pancreatic cancer [(B)RPC]. Background: Selected patients diagnosed with LAPC are increasingly undergoing resection after induction chemotherapy. To evaluate the benefit of this treatment approach, it is helpful to compare outcomes in resected patients with primary LAPC to outcomes in resected patients with primary (B)RPC. Methods: Two prospectively maintained nationwide databases were used for this study. Patients with (B)RPC undergoing upfront tumor resection and patients with resected LAPC after induction therapy were included. Outcomes were postoperative pancreas-specific complications, 90-day mortality, pathologic outcomes, disease-free interval, and overall survival. Results: Overall, 879 patients were included; 103 with LAPC (12%) and 776 with (B)RPC (88%). Patients with LAPC had a lower World Health Organization performance score and ageadjusted Charlson Comorbidity Index. Postoperative pancreas-specific complications were comparable between groups, except delayed gastric emptying grade C, which occurred more often in patients with LAPC (9% vs 3%, P = 0.03). Ninety-day mortality was comparable. About half of the patients in both groups [54% in LAPC vs 48% in (B)RPC, P = 0.21] had a radical resection (R0). Disease-free interval was 13 months in both groups (P = 0.12) and overall survival from the date of diagnosis was 24 months in patients with LAPC and 19 months in patients with (B)RPC (P = 0.34). Conclusions: In our nationwide prospective databases, pancreas-specific complications, mortality, and survival in patients with LAPC after pancreatectomy are comparable with those undergoing resection for (B)RPC. These outcomes suggest that postoperative morbidity and mortality after tumor resection in carefully selected patients with LAPC are acceptable.

AB - Objective: To evaluate short and long-term outcomes after pancreatectomy in patients with locally advanced pancreatic cancer (LAPC) compared with patients with (borderline) resectable pancreatic cancer [(B)RPC]. Background: Selected patients diagnosed with LAPC are increasingly undergoing resection after induction chemotherapy. To evaluate the benefit of this treatment approach, it is helpful to compare outcomes in resected patients with primary LAPC to outcomes in resected patients with primary (B)RPC. Methods: Two prospectively maintained nationwide databases were used for this study. Patients with (B)RPC undergoing upfront tumor resection and patients with resected LAPC after induction therapy were included. Outcomes were postoperative pancreas-specific complications, 90-day mortality, pathologic outcomes, disease-free interval, and overall survival. Results: Overall, 879 patients were included; 103 with LAPC (12%) and 776 with (B)RPC (88%). Patients with LAPC had a lower World Health Organization performance score and ageadjusted Charlson Comorbidity Index. Postoperative pancreas-specific complications were comparable between groups, except delayed gastric emptying grade C, which occurred more often in patients with LAPC (9% vs 3%, P = 0.03). Ninety-day mortality was comparable. About half of the patients in both groups [54% in LAPC vs 48% in (B)RPC, P = 0.21] had a radical resection (R0). Disease-free interval was 13 months in both groups (P = 0.12) and overall survival from the date of diagnosis was 24 months in patients with LAPC and 19 months in patients with (B)RPC (P = 0.34). Conclusions: In our nationwide prospective databases, pancreas-specific complications, mortality, and survival in patients with LAPC after pancreatectomy are comparable with those undergoing resection for (B)RPC. These outcomes suggest that postoperative morbidity and mortality after tumor resection in carefully selected patients with LAPC are acceptable.

U2 - 10.1097/SLA.0000000000006289

DO - 10.1097/SLA.0000000000006289

M3 - Article

C2 - 38557955

SN - 0003-4932

VL - 281

SP - 1026

EP - 1031

JO - Annals of surgery

JF - Annals of surgery

IS - 6

ER -

Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer

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