Outcomes of Distal Pancreatectomy for XXXX in the Netherlands: A Nationwide Retrospective Analysis.

@entity1 @entity1803 @entity5 @entity1124
BACKGROUND: Large multicenter series on outcomes and predictors of survival after distal pancreatectomy (DP) for @entity1124 ( @entity1124 ) are scarce. METHODS: Adults who underwent DP for @entity1124 in 17 Dutch pancreatic centers between January 2005 and September 2013 were analyzed retrospectively. The primary outcome was survival, and predictors of survival were identified using Cox regression analysis. RESULTS: In total, 761 consecutive @entity1 after DP were assessed, of whom 620 @entity1 were excluded because of non- @entity1124 histopathology (n  =  616) or a lack of data (n  =  4), leaving a total of 141 @entity1 included in the study [45  % (n  =  63) male, mean age 64  years (SD  =  10)]. Multivisceral resection was performed in 43 @entity1 (30  %) and laparoscopic resection was performed in 7 @entity1 (5  %). A major complication (Clavien-Dindo score of III or higher) occurred in 46 @entity1 (33  %). Mean @entity5 size was 44  mm (SD  23), and histopathological examination showed 70 R0 resections (50  %), while 30-day and 90-day mortality was 3 and 6  %, respectively. Overall, 63 @entity1 (45  %) received adjuvant chemotherapy. Median survival was 17  months [interquartile range (IQR) 13-21], with a median follow-up of 17  months (IQR 8-29). Cumulative survival at 1, 3 and 5  years was 64, 29, and 22  %, respectively. Independent predictors of worse postoperative survival were R1/R2 resection [hazard ratio (HR) 1.6, 95  % confidence interval (CI) 1.1-2.4], @entity1803 /pT4 stage (HR 1.9, 95  % CI 1.3-2.9), a major complication (HR 1.7, 95  % CI 1.1-2.5), and not receiving adjuvant chemotherapy (HR 1.5, 95  % CI 1.0-2.3). CONCLUSION: Survival after DP for @entity1124 is poor and is related to resection margin, @entity5 stage, surgical complications, and adjuvant chemotherapy. Further studies should assess to what extent prevention of surgical complications and more extensive use of adjuvant chemotherapy can improve survival.
