This study, utilizing the National Cancer Database, examines the efficacy of palliative surgery in locally advanced pancreatic cancer, revealing that while surgical palliation is associated with a modest increase in survival, it comes at the cost of significant hospitalizations and a heightened risk of readmission.
The following is a summary of “Locally advanced pancreatic cancer: Is surgical palliation associated with improved clinical outcome relative to medical palliation?,” published in the January 2024 issue of Surgery by Kramer et al.
This study investigates the efficacy of palliative surgery in the management of pancreatic cancer, a topic that currently lacks a clear definition. Utilizing the National Cancer Database, the researchers identified 9,107 patients with clinical stage cT4N0-2M0 pancreatic cancer who underwent curative-intent resection, palliative surgery, or medical palliation. Propensity-score matching was employed to create three comparable cohorts (1:1:1) based on comorbidities and stage.
The Kaplan-Meier method was then utilized to assess overall survival in the matched cohorts. The results revealed that among the included patients, 39% underwent curative intent surgery, 18% opted for surgical palliation, and 43% pursued medical palliation. Notably, patients undergoing resection and surgical palliation experienced substantial hospitalizations (11.0 ± 0.4 vs. 10.0 ± 0.3 days; p = 0.821) and higher rates of readmission (8.1% vs. 2.0%; p < 0.001) compared to those opting for medical palliation. Additionally, individuals undergoing surgical palliation exhibited a modest increase in survival compared to those choosing medical palliation (8.54 vs. 7.36 months; p < 0.0001).
In conclusion, for patients managing locally advanced pancreatic cancer, palliative surgery is associated with a marginal improvement in survival. Still, it entails significant hospitalization lengths and a heightened readmission risk. These findings contribute valuable insights to the ongoing discourse surrounding the role of palliative surgery in pancreatic cancer treatment.
Source: sciencedirect.com/science/article/abs/pii/S0002961024000199
