Serious complications of pancreatoduodenectomy correlate with lower rates of adjuvant chemotherapy: Results from the recurrence after Whipple's (RAW) study

Thomas B. Russell; Adam E. Frampton; Peter L. Labib; Fabio Ausania; Elizabeth Pando; Keith J. Roberts; Ambareen Kausar; Vasileios K. Mavroeidis; Gabriele Marangoni; Sarah C. Thomasset; Pavlos Lykoudis; Manuel Maglione; Nassir Alhaboob; Hassaan Bari; Andrew M. Smith; Duncan Spalding; Parthi Srinivasan; Brian R. Davidson; Ricky H. Bhogal; Daniel Croagh; Ismael Dominguez; Rohan Thakkar; Dhanny Gomez; Michael A. Silva; Pierfrancesco Lapolla; Andrea Mingoli; Alberto Porcu; Nehal S. Shah; Zaed Z.R. Hamady; Bilal Al-Sarrieh; Alejandro Serrablo; Adam Streeter; Jemimah Denson; Mark Puckett; Shang-Ming Zhou; Matthew Browning; Somaiah Aroori; Keith Roberts; Sarah Thomasset; Adam Frampton; Andrew Smith; Brian Davidson; Ricky Bhogal; Michael Silva; Nehal Sureshkumar Shah; Zaed Hamady; Carolina Gonzalez-Abos; Nair Fernandes; Elsa Garcia Moller; Cristina Dopazo Taboada; Rupaly Pande; Jameel Alfarah; Samik Bandyopadhyay; Ahmed Abdelrahim; Ayesha Khan; Caitlin Jordan; Jonathan R.E. Rees; Harry Blege; William Cambridge; Olga White; Sarah Blacker; Jessie Blackburn; Casie Sweeney; Daniel Field; Mohammed Gouda; Ruben Bellotti; Hytham K.S. Hamid; Hassan Ahmed; Catherine Moriarty; Louise White; Mark Priestley; Kerry Bode; Judith Sharp; Rosie Wragg; Beverley Jackson; Samuel Craven; Matyas Fehervari; Madhava Pai; Laith Alghazawi; Anjola Onifade; Julliette Ribaud; Ashitha Nair; Michael Mariathasan; Niamh Grayson; Stephanos Pericleous; Krishna Patel; Conrad Shaw; Nolitha Morare; Mohamad Khish Zaban; Joseph Doyle; Alan Guerrero; Andre Moguel; Carlos Chan; Michael Jones; Edward Buckley; Nasreen Akter; Kyle Treherne; Gregory Gordon; Daniel Hughes; Tomas Urbonas; Gioia Brachini; Roberto Caronna; Piero Chirletti; Teresa Perra; Nurul Nadhirah Abd Kahar; Thomas Hall; Nabeegh Nadeem; Shoura Karar; Ali Arshad; Adam Yarwood; Mohammed Hammoda; Maria Artigas; Sandra Paterna-López

doi:10.1016/j.ejso.2023.04.018

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Serious complications of pancreatoduodenectomy correlate with lower rates of adjuvant chemotherapy: Results from the recurrence after Whipple's (RAW) study

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Serious complications of pancreatoduodenectomy correlate with lower rates of adjuvant chemotherapy: Results from the recurrence after Whipple's (RAW) study

Thomas B. Russell, Adam E. Frampton, Peter L. Labib, Fabio Ausania, Elizabeth Pando, Keith J. Roberts, Ambareen Kausar, Vasileios K. Mavroeidis, Gabriele Marangoni, Sarah C. Thomasset, …

European journal of surgical oncology, Vol.49(9), pp.106919-106919

01/09/2023

DOI: https://doi.org/10.1016/j.ejso.2023.04.018

PMID: 37330348

Abstract

Adjuvant chemotherapy

Morbidity

Neoadjuvant therapy

Pancreatic ductal carcinoma

Pancreaticoduodenectomy

Postoperative complications

Adjuvant chemotherapy (AC) can prolong overall survival (OS) after pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). However, fitness for AC may be influenced by postoperative recovery. We aimed to investigate if serious (Clavien-Dindo grade ≥ IIIa) postoperative complications affected AC rates, disease recurrence and OS. Data were extracted from the Recurrence After Whipple's (RAW) study (n = 1484), a retrospective study of PD outcomes (29 centres from eight countries). Patients who died within 90-days of PD were excluded. The Kaplan-Meier method was used to compare OS in those receiving or not receiving AC, and those with and without serious postoperative complications. The groups were then compared using univariable and multivariable tests. Patients who commenced AC (vs no AC) had improved OS (median difference: (MD): 201 days), as did those who completed their planned course of AC (MD: 291 days, p < 0.0001). Those who commenced AC were younger (mean difference: 2.7 years, p = 0.0002), more often (preoperative) American Society of Anesthesiologists (ASA) grade I-II (74% vs 63%, p = 0.004) and had less often experienced a serious postoperative complication (10% vs 18%, p = 0.002). Patients who developed a serious postoperative complication were less often ASA grade I-II (52% vs 73%, p = 0.0004) and less often commenced AC (58% vs 74%, p = 0.002). In our multicentre study of PD outcomes, PDAC patients who received AC had improved OS, and those who experienced a serious postoperative complication commenced AC less frequently. Selected high-risk patients may benefit from targeted preoperative optimisation and/or neoadjuvant chemotherapy.

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Title: Serious complications of pancreatoduodenectomy correlate with lower rates of adjuvant chemotherapy: Results from the recurrence after Whipple's (RAW) study
Creators: Thomas B. Russell - University Hospitals Plymouth NHS Trust
Adam E. Frampton - Royal Surrey NHS Foundation Trust
Peter L. Labib - University Hospitals Plymouth NHS Trust
Fabio Ausania - Hospital Clínic de Barcelona
Elizabeth Pando - Vall d'Hebron Hospital Universitari
Keith J. Roberts - University Hospitals Birmingham NHS Foundation Trust
Ambareen Kausar - East Lancashire Hospitals NHS Trust
Vasileios K. Mavroeidis - University Hospitals Bristol NHS Foundation Trust
Gabriele Marangoni - University Hospital Coventry
Sarah C. Thomasset - NHS Lothian
Pavlos Lykoudis - University of Hull
Manuel Maglione - Innsbruck Medical University
Nassir Alhaboob - Sina
Hassaan Bari - Shaukat Khanum Memorial Cancer Hospital and Research Center
Andrew M. Smith - Leeds Teaching Hospitals NHS Trust
Duncan Spalding - Imperial College Healthcare NHS Trust
Parthi Srinivasan - King's College Hospital NHS Foundation Trust
Brian R. Davidson - Royal Free London NHS Foundation Trust
Ricky H. Bhogal - Royal Marsden NHS Foundation Trust
Daniel Croagh - Monash Medical Centre
Ismael Dominguez - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Rohan Thakkar - Newcastle upon Tyne Hospitals NHS Foundation Trust
Dhanny Gomez - Nottingham University Hospitals NHS Trust
Michael A. Silva - Oxford University Hospitals NHS Trust
Pierfrancesco Lapolla - Policlinico Umberto I
Andrea Mingoli - Policlinico Umberto I
Alberto Porcu - Azienda Ospedaliero Universitaria di Sassari
Nehal S. Shah - Sheffield Teaching Hospitals NHS Foundation Trust
Zaed Z.R. Hamady - University Hospital Southampton NHS Foundation Trust
Bilal Al-Sarrieh - Swansea Bay University Health Board
Alejandro Serrablo - Hospital Universitario Miguel Servet
Peter L. Labib - University Hospitals Plymouth NHS Trust
Thomas B. Russell - University Hospitals Plymouth NHS Trust
Adam Streeter - University Hospitals Plymouth NHS Trust
Jemimah Denson - University Hospitals Plymouth NHS Trust
Mark Puckett - University Hospitals Plymouth NHS Trust
Shang-Ming Zhou - University Hospitals Plymouth NHS Trust
Matthew Browning - University Hospitals Plymouth NHS Trust
Somaiah Aroori - University of Plymouth
Fabio Ausania - Hospital Clínic de Barcelona
Elizabeth Pando - Vall d'Hebron Hospital Universitari
Keith Roberts - University Hospitals Birmingham NHS Foundation Trust
Ambareen Kausar - East Lancashire Hospitals NHS Trust
Vasileios K. Mavroeidis - University Hospitals Bristol NHS Foundation Trust
Gabriele Marangoni - University Hospital Coventry
Sarah Thomasset - NHS Lothian
Adam Frampton - Royal Surrey NHS Foundation Trust
Pavlos Lykoudis - University of Hull
Manuel Maglione - Innsbruck Medical University
Nassir Alhaboob - Sina
Hassaan Bari - Shaukat Khanum Memorial Cancer Hospital and Research Center
Andrew Smith - Leeds Teaching Hospitals NHS Trust
Duncan Spalding - Imperial College Healthcare NHS Trust
Parthi Srinivasan - King's College Hospital NHS Foundation Trust
Brian Davidson - Royal Free London NHS Foundation Trust
Ricky Bhogal - Royal Marsden NHS Foundation Trust
Daniel Croagh - Monash Medical Centre
Ismael Dominguez - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Rohan Thakkar - Newcastle upon Tyne Hospitals NHS Foundation Trust
Dhanny Gomez - Nottingham University Hospitals NHS Trust
Michael Silva - Oxford University Hospitals NHS Trust
Pierfrancesco Lapolla - Policlinico Umberto I
Andrea Mingoli - Policlinico Umberto I
Alberto Porcu - Azienda Ospedaliero Universitaria di Sassari
Nehal Sureshkumar Shah - Sheffield Teaching Hospitals NHS Foundation Trust
Zaed Hamady - University Hospital Southampton NHS Foundation Trust
Bilal Al-Sarrieh - Swansea Bay University Health Board
Alejandro Serrablo - Hospital Universitario Miguel Servet
Carolina Gonzalez-Abos - Hospital Clínic de Barcelona
Nair Fernandes - Hospital Universitari Vall d'Hebron
Elsa Garcia Moller - Hospital Universitari Vall d'Hebron
Cristina Dopazo Taboada - Hospital Universitari Vall d'Hebron
Rupaly Pande - University Hospitals Birmingham NHS Foundation Trust
Jameel Alfarah - University Hospitals Birmingham NHS Foundation Trust
Samik Bandyopadhyay - East Lancashire Hospitals NHS Trust
Ahmed Abdelrahim - East Lancashire Hospitals NHS Trust
Ayesha Khan - East Lancashire Hospitals NHS Trust
Caitlin Jordan - University Hospitals Bristol NHS Foundation Trust
Jonathan R.E. Rees - University Hospitals Bristol NHS Foundation Trust
Harry Blege - University Hospital Coventry
William Cambridge - NHS Lothian
Olga White - NHS Lothian
Sarah Blacker - NHS Lothian
Jessie Blackburn - Royal Surrey NHS Foundation Trust
Casie Sweeney - Royal Surrey NHS Foundation Trust
Daniel Field - Monash Medical Centre
Mohammed Gouda - Hull University Teaching Hospitals NHS Trust, Hull, UK
Ruben Bellotti - University of Innsbruck
Hytham K.S. Hamid - Sina
Hassan Ahmed - Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
Catherine Moriarty - Leeds Teaching Hospitals NHS Trust
Louise White - Leeds Teaching Hospitals NHS Trust
Mark Priestley - Leeds Teaching Hospitals NHS Trust
Kerry Bode - Leeds Teaching Hospitals NHS Trust
Judith Sharp - Leeds Teaching Hospitals NHS Trust
Rosie Wragg - Leeds Teaching Hospitals NHS Trust
Beverley Jackson - Leeds Teaching Hospitals NHS Trust
Samuel Craven - Leeds Teaching Hospitals NHS Trust
Matyas Fehervari - Imperial College Healthcare NHS Trust
Madhava Pai - Imperial College Healthcare NHS Trust
Laith Alghazawi - Imperial College Healthcare NHS Trust
Anjola Onifade - Imperial College Healthcare NHS Trust
Julliette Ribaud - King's College Hospital NHS Foundation Trust
Ashitha Nair - King's College Hospital NHS Foundation Trust
Michael Mariathasan - Oxford University Hospitals NHS Trust
Niamh Grayson - King's College Hospital NHS Foundation Trust
Stephanos Pericleous - Royal Free London NHS Foundation Trust
Krishna Patel - Royal Free London NHS Foundation Trust
Conrad Shaw - Royal Free London NHS Foundation Trust
Nolitha Morare - Royal Free London NHS Foundation Trust
Mohamad Khish Zaban - Royal Free London NHS Foundation Trust
Joseph Doyle - Royal Marsden NHS Foundation Trust
Vasileios K. Mavroeidis - University Hospitals Bristol NHS Foundation Trust
Alan Guerrero - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Andre Moguel - Policlinico Umberto I
Carlos Chan - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Michael Jones - Oxford University Hospitals NHS Trust
Edward Buckley - Newcastle upon Tyne Hospitals NHS Foundation Trust
Nasreen Akter - Newcastle upon Tyne Hospitals NHS Foundation Trust
Kyle Treherne - Newcastle upon Tyne Hospitals NHS Foundation Trust
Gregory Gordon - Nottingham University Hospitals NHS Trust
Daniel Hughes - Monash Medical Centre
Tomas Urbonas - University of Oxford
Gioia Brachini - Sapienza University of Rome
Roberto Caronna - Sapienza University of Rome
Piero Chirletti - Sapienza University of Rome
Teresa Perra - Azienda Ospedaliero Universitaria di Sassari
Nurul Nadhirah Abd Kahar - Sheffield Teaching Hospitals NHS Foundation Trust
Thomas Hall - NHS Lothian
Nabeegh Nadeem - Sheffield Teaching Hospitals NHS Foundation Trust
Shoura Karar - University Hospital Southampton NHS Foundation Trust
Ali Arshad - University Hospital Southampton NHS Foundation Trust
Adam Yarwood - Royal Surrey NHS Foundation Trust
Mohammed Hammoda - Swansea Bay University Health Board
Maria Artigas - Hospital Universitario Miguel Servet
Sandra Paterna-López - Hospital Universitario Miguel Servet
Somaiah Aroori - University of Plymouth
Publication Details: European journal of surgical oncology, Vol.49(9), pp.106919-106919
Publisher: Elsevier Ltd
Date published: 01/09/2023
Identifiers: 99828459002346
Academic Unit: School of Biosciences
Language: English
Resource Type: Journal article

Serious complications of pancreatoduodenectomy correlate with lower rates of adjuvant chemotherapy: Results from the recurrence after Whipple's (RAW) study

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