caa a22 4500 445336358 CHVBK 20180317142756.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1604-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1604-8 Recurrence Pattern and Prognosis of Pancreatic Cancer After Pancreatic Fistula [Elektronische Daten] [Shunji Nagai, Tsutomu Fujii, Yasuhiro Kodera, Mitsuro Kanda, Tevfik Sahin, Akiyuki Kanzaki, Masamichi Hayashi, Hiroyuki Sugimoto, Shuji Nomoto, Shin Takeda, Satoshi Morita, Akimasa Nakao] Background: The negative impact of anastomotic leakage on cancer-specific survival and recurrence patterns has been recognized in colorectal cancer. In pancreatic cancer, pancreatic fistula (PF) is a serious morbidity, but its negative effect on long-term outcome remains to be elucidated. The aim of this study was to determine the impact of PF on pancreatic cancer recurrence. Methods: The medical records of 184 patients with curative pancreatectomy for pancreatic cancer were reviewed. PF was scored on the basis of the International Study Group of Pancreatic Fistula classification. Overall and disease-free survivals and recurrence patterns were analyzed. Grade A PF was excluded because the negative effects can be negligible. Results: PF occurred in 51 of the 184 patients (27.7%). The mortality related to PF was 0.5% (1 of 184). PF was an independent risk factor for peritoneal recurrence (hazard ratio 3.974; 95% confidence interval 1.345-11.737; P=0.013). According to the analysis of disease-free survival in patients with peritoneal recurrence, time to recurrence was shorter and the survival rate was worse in patients with PF than in those without PF (5.6 vs. 8.2months; 6-month survival, 40 vs. 71%; 1-year survival, 7 vs. 19%; P=0.053). PF was an independent prognostic factor after multivariate analysis (hazard ratio 3.257; 95% confidence interval 1.201-8.828; P=0.020). Conclusions: PF was statistically significantly related to peritoneal recurrence, and patients with PF developed peritoneal recurrence earlier than those without PF. With regard to the development of peritoneal recurrence, PF may be considered to be a negative prognostic factor. Society of Surgical Oncology, 2011 Nagai Shunji Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Fujii Tsutomu Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Kodera Yasuhiro Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Kanda Mitsuro Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Sahin Tevfik Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Kanzaki Akiyuki Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Hayashi Masamichi Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Sugimoto Hiroyuki Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Nomoto Shuji Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Takeda Shin Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Morita Satoshi Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan aut Nakao Akimasa Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2329-2337 1068-9265 18:8<2329 2011 18 10434 https://doi.org/10.1245/s10434-011-1604-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1604-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nagai Shunji Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Fujii Tsutomu Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kodera Yasuhiro Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kanda Mitsuro Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Sahin Tevfik Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kanzaki Akiyuki Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Hayashi Masamichi Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Sugimoto Hiroyuki Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Nomoto Shuji Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Takeda Shin Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Morita Satoshi Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan aut NATIONALLICENCE 700 1- Nakao Akimasa Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2329-2337 1068-9265 18:8<2329 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer