Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit

Rijssen, L. van; Koerkamp, B. Groot; Zwart, M.; Bonsing, B.; Bosscha, K.; Dam, Ronald M. van; Eijck, Casper van; Gerhards, Michael F.; Harst, E. van der; Hingh, Ignace de; Jong, K. De; Kazemier, Geert; Klaase, Joost M.; Laarhoven, Cornelis J. H. M. van; Molenaar, I.; Patijn, Gijsbert A.; Rupert, C.; Santvoort, Hjalmar van; Scheepers, Joris J.; Schelling, George van der; Busch, O.; Besselink, M.

doi:10.1016/j.hpb.2019.10.615

Cited by 22 publications

(49 citation statements)

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“…PD is considered a complex surgical procedure and associated with significant postoperative morbidity and mortality, even in modern series. [1][2][3] The long-term survival from surgery is very limited for adenocarcinoma, 4 and uncertain for cystic neoplasms, 5 and quality-of-life following PD can be substantially impaired. 6,7 Therefore, it is important that short term outcomes are monitored and optimized if such surgery is to be justified.…”

Section: Introductionmentioning

confidence: 99%

The effect of centralization on short term outcomes of pancreatoduodenectomy in a universal health care system

Nymo

Søreide

Kleive

et al. 2019

HPB

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Background: Centralization of pancreatic resections is advocated due to a volume-outcome association. Pancreatic surgery is in Norway currently performed only in five teaching hospitals. The aim was to describe the short-term outcomes after pancreatoduodenectomy (PD) within the current organizational model and to assess for regional disparities.Methods: All patients who underwent PD in Norway between 2012 and 2016 were identified. Mortality (90 days) and relaparotomy (30 days) were assessed for predictors including demographic data and multi-visceral or vascular resection. Aggregated length-of-stay and national and regional incidences of the procedure were also analysed.Results: A total of 930 patients underwent PD during the study period. In-hospital mortality occurred in 20 patients (2%) and 34 patients (4%) died within 90 days. Male gender, age, multi-visceral resection and relaparotomy were independent predictors of 90-day mortality. Some 131 patients (14%) had a relaparotomy, with male gender and multi-visceral resection as independent predictors. There was no difference between regions in procedure incidence or 90-day mortality. There was a disparity within the regions in the use of vascular resection (p = 0.021). Conclusion:The short-term outcomes after PD in Norway are acceptable and the 90-day mortality rate is low. The outcomes may reflect centralization of pancreatic surgery.

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Section: Introductionmentioning

confidence: 99%

The effect of centralization on short term outcomes of pancreatoduodenectomy in a universal health care system

Nymo

Søreide

Kleive

et al. 2019

HPB

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“…A previous study reported a high quality of DPCA data. 36 In conclusion, this nationwide study found that EBD prior to pancreatoduodenectomy still frequently involved plastic stents. SEMS placement seemed to be associated with lower risks of cholangitis, less postoperative pancreatic fistula, and a shorter postoperative hospital stay but not with an increased risk of pancreatitis.…”

Section: Discussionmentioning

confidence: 61%

Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

Latenstein

Mackay

Huijgevoort

et al. 2021

HPB

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Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes. Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017)(2018). Multivariable logistic and linear regression models were performed.Results: In total, 575/1056 patients (62.0%) underwent preoperative EBD: 246 SEMS (42.8%) and 329 plastic stents (57.2%). EBD-related complications were comparable between the groups (44/246 (17.9%) vs. 64/329 (19.5%), p = 0.607), including pancreatitis (22/246 (8.9%) vs. 25/329 (7.6%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1%) vs. 32/329 (9.7%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6%) vs. 90/329 (27.4%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8%) vs. 61/329 (18.5%), p = 0.004; OR 0.50 95%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95%CI −5.16 to −0.57, p = 0.014) were less after SEMS placement. Conclusion:This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.

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“…During follow-up, serum and EDTA plasma samples are collected at the first postoperative visit to the out-patient clinic, 6 months, 12 months, and 24 months postoperatively, and at recurrence. Data are collected in conjunction with the Dutch Pancreatic Cancer Audit 6 and via Castor Electronic Data Capture (Amsterdam, the Netherlands). Researchers can submit a study proposal for use of the samples to the scientific committee (pancreasparel@dpcg.nl) of the Dutch Pancreatic Cancer Group.…”

Section: Dutch Pancreas Biobankmentioning

confidence: 99%

“…For this study additional data regarding preoperative imaging and biomarker characteristics (location of the tumor, tumor diameter, clinical lymph node status, and venous and arterial involvement on imaging, and bilirubin level in clinical laboratory) were obtained via the Dutch Pancreatic Cancer Audit. 6 All data were retrieved from medical records by a trained research nurse or MD.…”

Section: Definitionsmentioning

confidence: 99%

Preoperative serum ADAM12 levels as a stromal marker for overall survival and benefit of adjuvant therapy in patients with resected pancreatic and periampullary cancer

Strijker

Sijde

Suker

et al. 2021

HPB

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Background: We evaluated the stroma marker A Disintegrin And Metalloprotease 12 (ADAM12) as a preoperative prognostic and treatment-predictive marker for overall survival (OS) in pancreatic ductal adenocarcinoma (PDAC) and periampullary cancers.Methods: Materials were derived from the prospective nationwide Dutch Pancreas Biobank (2015)(2016)(2017). We included patients who underwent resection because of PDAC/periampullary cancer or non-invasive IPMN (control group) and had a preoperative serum sample available. ADAM12 levels were dichotomized using a pre-defined cut-off (316 pg/mL). Univariable and multivariable Cox regression analyses (backward selection) were performed.Results: Median ADAM12 levels were 161 (IQR 79-352) pg/mL in 215 PDAC and periampullary adenocarcinomas. High ADAM12 levels (>316 pg/mL) predicted poor OS in the total group of pancreatic and periampullary adenocarcinomas (P = 0.04), but not after adjustment. In distal cholangiocarcinoma (n = 33), high ADAM12 levels predicted poor OS in univariable analysis (P = 0.02), but not in PDAC (P = 0.63). PDAC patients (n = 135) with high ADAM12 levels benefited from adjuvant treatment (median OS 27 vs 14 months, P = 0.02), whereas those with low levels did not (21 vs 21 months, P = 0.87). Conclusion: High circulating ADAM12 levels, as a proxy for activated stroma, predict survival benefit from adjuvant chemotherapy in PDAC, requiring validation in future studies.

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Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit

Abstract: Background: Pancreatic cystic neoplasms include serous tumors, pseudopapillary neoplasms mucinous tumors, and IPMN. Sendai criteria, last update Fukuoka criteria, have increased attention on IPMN. Methods: We retrospectively reviewed patients with

Cited by 22 publications

References 0 publications

The effect of centralization on short term outcomes of pancreatoduodenectomy in a universal health care system

The effect of centralization on short term outcomes of pancreatoduodenectomy in a universal health care system

Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

Preoperative serum ADAM12 levels as a stromal marker for overall survival and benefit of adjuvant therapy in patients with resected pancreatic and periampullary cancer

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