Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective

Background: Little has been published regarding presenting symptoms, investigations and outcomes for patients with pancreatic cancer in Australia. Data from a series of patients undergoing attempted resection in Queensland, Australia, are presented with the aim of assisting development of consistent...

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Main Authors: Wylie, N., Adib, R., Barbour, A., Fawcett, J., Hill, A., Lynch, S., Martin, I., O'Rourke, T., Puhalla, H., Rutherford, L., Slater, K., Whiteman, D., Neale, R., Fritschi, Lin
Format: Journal Article
Published: John Wiley & Sons 2013
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/41963
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author Wylie, N.
Adib, R.
Barbour, A.
Fawcett, J.
Hill, A.
Lynch, S.
Martin, I.
O'Rourke, T.
Puhalla, H.
Rutherford, L.
Slater, K.
Whiteman, D.
Neale, R.
Fritschi, Lin
author_facet Wylie, N.
Adib, R.
Barbour, A.
Fawcett, J.
Hill, A.
Lynch, S.
Martin, I.
O'Rourke, T.
Puhalla, H.
Rutherford, L.
Slater, K.
Whiteman, D.
Neale, R.
Fritschi, Lin
author_sort Wylie, N.
building Curtin Institutional Repository
collection Online Access
description Background: Little has been published regarding presenting symptoms, investigations and outcomes for patients with pancreatic cancer in Australia. Data from a series of patients undergoing attempted resection in Queensland, Australia, are presented with the aim of assisting development of consistent strategies in disease management.Methods: We reviewed the medical records of 121 patients who underwent attempted surgical resection and who took part in a case-control study between 2007 and 2009. Information relating to symptoms, investigations, surgical procedures and outcomes was captured.Results: The mean age was 63 years and 60% were men. The most common presenting symptoms were jaundice (64%) and pain (63%). Over 80% of patients had multiple imaging investigations or laparoscopy prior to surgery. Seventy-eight patients (64%) had a completed resection and 23% of these had involved margins. The presence of metastases and/or involvement of vessels or adjacent structures precluded resection in the remaining patients. The 1-year survival for patients whose resections were completed was 77% compared with 51% for those whose tumours were notresectable (P = 0.004). There was no 30-day mortality and 68% of patients were alive 1 year after diagnosis. Resections were performed in 11 different hospitals but over 90% of patients underwent their surgery in one of five high-volume centres.Conclusion: The Queensland experience is consistent with that reported internationally. A significant proportion of attempted resections was not completed because preoperative staging underestimated disease extent. Most patients with potentially resectable disease are being treated in high-volume centres.
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spelling curtin-20.500.11937-419632017-02-28T01:39:37Z Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective Wylie, N. Adib, R. Barbour, A. Fawcett, J. Hill, A. Lynch, S. Martin, I. O'Rourke, T. Puhalla, H. Rutherford, L. Slater, K. Whiteman, D. Neale, R. Fritschi, Lin therapeutics neoplasms general surgery Australia pancreatic neoplasms Background: Little has been published regarding presenting symptoms, investigations and outcomes for patients with pancreatic cancer in Australia. Data from a series of patients undergoing attempted resection in Queensland, Australia, are presented with the aim of assisting development of consistent strategies in disease management.Methods: We reviewed the medical records of 121 patients who underwent attempted surgical resection and who took part in a case-control study between 2007 and 2009. Information relating to symptoms, investigations, surgical procedures and outcomes was captured.Results: The mean age was 63 years and 60% were men. The most common presenting symptoms were jaundice (64%) and pain (63%). Over 80% of patients had multiple imaging investigations or laparoscopy prior to surgery. Seventy-eight patients (64%) had a completed resection and 23% of these had involved margins. The presence of metastases and/or involvement of vessels or adjacent structures precluded resection in the remaining patients. The 1-year survival for patients whose resections were completed was 77% compared with 51% for those whose tumours were notresectable (P = 0.004). There was no 30-day mortality and 68% of patients were alive 1 year after diagnosis. Resections were performed in 11 different hospitals but over 90% of patients underwent their surgery in one of five high-volume centres.Conclusion: The Queensland experience is consistent with that reported internationally. A significant proportion of attempted resections was not completed because preoperative staging underestimated disease extent. Most patients with potentially resectable disease are being treated in high-volume centres. 2013 Journal Article http://hdl.handle.net/20.500.11937/41963 John Wiley & Sons restricted
spellingShingle therapeutics
neoplasms
general surgery
Australia
pancreatic neoplasms
Wylie, N.
Adib, R.
Barbour, A.
Fawcett, J.
Hill, A.
Lynch, S.
Martin, I.
O'Rourke, T.
Puhalla, H.
Rutherford, L.
Slater, K.
Whiteman, D.
Neale, R.
Fritschi, Lin
Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title_full Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title_fullStr Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title_full_unstemmed Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title_short Surgical Management in Patients With Pancreatic Cancer: a Queensland Perspective
title_sort surgical management in patients with pancreatic cancer: a queensland perspective
topic therapeutics
neoplasms
general surgery
Australia
pancreatic neoplasms
url http://hdl.handle.net/20.500.11937/41963