Abstract

Background

Dutch guidelines indicate that treatment of pancreatic head and periampullary malignancies should be started within 3 weeks of the multidisciplinary team (MDT) meeting. This study aimed to assess the impact of time to surgery on oncological outcomes.

Methods

This was a retrospective population‐based cohort study of patients with pancreatic head and periampullary malignancies included in the Netherlands Cancer Registry. Patients scheduled for pancreatoduodenectomy and who were discussed in an MDT meeting from May 2012 to December 2016 were eligible. Time to surgery was defined as days between the final preoperative MDT meeting and surgery, categorized in tertiles (short interval, 18 days or less; intermediate, 19–32 days; long, 33 days or more). Oncological outcomes included overall survival, resection rate and R0 resection rate.

Results

A total of 2027 patients were included, of whom 677, 665 and 685 had a short, intermediate and long time interval to surgery respectively. Median time to surgery was 25 (i.q.r. 14–36) days. Longer time to surgery was not associated with overall survival (hazard ratio 0·99, 95 per cent c.i. 0·87 to 1·13; P = 0·929), resection rate (relative risk (RR) 0·96, 95 per cent c.i. 0·91 to 1·01; P = 0·091) or R0 resection rate (RR 1·01, 0·94 to 1·09; P = 0·733). Patients with pancreatic ductal adenocarcinoma and a long time interval had a lower resection rate (RR 0·92, 0·85 to 0·99; P = 0·029).

Discussion

A longer time interval between the last MDT meeting and pancreatoduodenectomy did not decrease overall survival.

Details

Title
Impact of time interval between multidisciplinary team meeting and intended pancreatoduodenectomy on oncological outcomes
Author
Steen, M W 1 ; van Rijssen, L B 2 ; Festen, S 3 ; Busch, O R 2 ; B. Groot Koerkamp 4   VIAFID ORCID Logo  ; L. G. van der Geest 5 ; de Hingh, I H 6 ; van Santvoort, H C 7 ; Besselink, M G 2 ; Gerhards, M F 3 

1  Department of Surgery, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, the Netherlands; Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands 
2  Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands 
3  Department of Surgery, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, the Netherlands 
4  Department of Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands 
5  Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, the Netherlands 
6  Regional Academic Cancer Centre Utrecht, St Antonius Hospital Nieuwegein and University Medical Centre, Utrecht Cancer Centre Utrecht, Eindhoven, the Netherlands 
7  Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands 
Pages
884-892
Section
Original articles
Publication year
2020
Publication date
Oct 2020
Publisher
Oxford University Press
e-ISSN
24749842
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/bjs5.50319
ProQuest document ID
2447505739
Copyright
© 2020. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.