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Impact of surgical wait times on oncologic outcomes in resectable pancreas adenocarcinoma
- Source :
- HPB. 22:892-899
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Timely surgical resection in patients with suspected or diagnosed pancreas adenocarcinoma is an essential part of care. We hypothesized that longer surgical wait time was associated with worse oncologic outcomes. Methods A retrospective cohort of patients (N = 144) with resectable pancreas adenocarcinoma was divided into four wait time groups ( 12 weeks), defined from the time of diagnosis on cross-sectional imaging. Overall and recurrence-free survival were analyzed using the Kaplan–Meier method and Cox proportional hazards regression. A higher rate of conversion to palliative bypass in patients waiting over 4 weeks was observed and further analyzed using post-hoc multivariate regression. Results On multivariable analysis, longer wait time was associated with improved overall (HR 0.49, 95% CI: 0.28–0.85) and recurrence-free survival (HR 0.29, 95% CI: 0.15–0.56) in >12 weeks compared to Conclusion Wait time over 8 weeks was associated with a higher rate of palliative bypass. There was an improvement in overall and recurrence-free survival in patients who waited over 12 weeks, likely due to selection bias.
- Subjects :
- Surgical resection
Selection bias
medicine.medical_specialty
Pancreas adenocarcinoma
Multivariate statistics
Hepatology
business.industry
media_common.quotation_subject
Gastroenterology
Retrospective cohort study
030230 surgery
Wait time
Surgery
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
Cox proportional hazards regression
medicine
In patient
business
media_common
Subjects
Details
- ISSN :
- 1365182X
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- HPB
- Accession number :
- edsair.doi...........b0730eec56eeac419d0b2a9486f446cd