TITLE:
The Effects of Surgical Exploration on Survival of Unresectable Pancreatic Carcinoma: A Retrospective Case-Control Study
AUTHORS:
Daniel Åkerberg, Daniel Ansari, Roland Andersson, Bobby Tingstedt
KEYWORDS:
Pancreatic Cancer, Surgical Exploration, Palliative Treatment, Survival
JOURNAL NAME:
Journal of Biomedical Science and Engineering,
Vol.10 No.1,
January
19,
2017
ABSTRACT: Background: Surgery may trigger the release of inflammatory factors, including cytokines, growth factors and angiogenic factors, which may stimulate tumor growth and progression. The present study was undertaken to evaluate the impact of surgical exploration on survival of patients with potentially resectable pancreatic cancer, who intraoperatively were found to have unresectable disease. Methods: Patients with pancreatic adenocarcinoma undergoing surgical exploration, without tumor resection, at our institution between 2009 and 2014, were selected and case-matched to patients who underwent primary palliative treatment. Results: A total of 116 patients were included. The surgical exploration group (n = 29) had significantly lower CRP levels at the time of diagnosis compared to the palliative controls (n = 87), 4 mg/L vs 12 mg/L; p = 0.004. The percentage of patients who received palliative chemotherapy was comparable between groups, but the time until start of chemotherapy was significantly longer in the surgical exploration group, 2 months vs 1 months; p Conclusion: In this case-control study, we could not detect any survival disadvantage due to surgical exploration in the setting of unresectable pancreatic cancer. Surgical exploration was associated with delayed start of palliative chemotherapy, but the percentage of patients who ultimately received chemotherapy was comparable to patients undergoing primary palliative treatment.