Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancy

Amr, B., Shahtahmassebi, G. ORCID: 0000-0002-0630-2750, Briggs, C.D., Bowles, M.J., Aroori, S. and Stell, D.A., 2016. Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancy. HPB, 18 (4), pp. 354-359. ISSN 1365-182X

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Abstract

Background: Delay between diagnosis of peri-ampullary cancer (PC) and surgery may allow tumour progression and affect outcome. This study aims to explore associations of interval to surgery (IS) with pathological outcomes and survival in patients with PC. Method: A database review of all patients undergoing surgery between 2006 and 2014 was undertaken. IS was measured from diagnosis by imaging. Potential association between IS and survival was measured using Cox regression analysis, and between IS and pathological outcome with multivariate logistic analysis. Results: 388 patients underwent surgery. The median IS was 49 days (1-551 days), and was not associated with any of the evaluated outcomes in patients with pancreatic (149) or distal bile duct (46) cancer. For patients with ampullary cancer (71) longer IS was associated with improved survival, with median survival of 1.3, 3.1 and 4.3 years for patients waiting <1 (9), 1-2 (37) and >2 (25) months for surgery (p=0.036). A higher rate of margin positivity (31.4%) was also noted among patients who waited less than the median IS compared to those waiting longer than this interval (11.4%) (p=0.032). Conclusion: For patients with ampullary cancer there is a paradoxical improvement in outcome among those with a longer IS, which may be explained by progression to inoperability of more aggressive lesions.

Item Type: Journal article
Publication Title: HPB
Creators: Amr, B., Shahtahmassebi, G., Briggs, C.D., Bowles, M.J., Aroori, S. and Stell, D.A.
Publisher: Elsevier
Date: April 2016
Volume: 18
Number: 4
ISSN: 1365-182X
Identifiers:
NumberType
10.1016/j.hpb.2015.10.013DOI
Divisions: Schools > School of Science and Technology
Depositing User: Jonathan Gallacher
Date Added: 24 May 2016 12:31
Last Modified: 09 Jun 2017 14:02
URI: http://irep.ntu.ac.uk/id/eprint/27871

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