TY - JOUR
T1 - Preoperative Characteristics of Patients with Presumed Pancreatic Cancer but Ultimately Benign Disease
T2 - A Multicenter Series of 344 Pancreatoduodenectomies
AU - Gerritsen, Arja
AU - Molenaar, I. Quintus
AU - Bollen, Thomas L.
AU - Nio, C. Yung
AU - Dijkgraaf, Marcel G.
AU - van Santvoort, Hjalmar C.
AU - Offerhaus, G. Johan
AU - Brosens, Lodewijk A.
AU - Biermann, Katharina
AU - Sieders, Egbert
AU - de Jong, Koert P.
AU - van Dam, Ronald M.
AU - van der Harst, Erwin
AU - van Goor, Harry
AU - van Ramshorst, Bert
AU - Bonsing, Bert A.
AU - de Hingh, Ignace H.
AU - Gerhards, Michael F.
AU - van Eijck, Casper H.
AU - Gouma, Dirk J.
AU - Borel Rinkes, Inne H M
AU - Busch, Olivier R C
AU - Besselink, Marc G.
PY - 2014/10/8
Y1 - 2014/10/8
N2 - Background: Preoperative differentiation between malignant and benign pancreatic tumors can be difficult. Consequently, a proportion of patients undergoing pancreatoduodenectomy for suspected malignancy will ultimately have benign disease. The aim of this study was to compare preoperative clinical and diagnostic characteristics of patients with unexpected benign disease after pancreatoduodenectomy with those of patients with confirmed (pre)malignant disease.Methods: We performed a multicenter retrospective cohort study in 1,629 consecutive patients undergoing pancreatoduodenectomy for suspected malignancy between 2003 and 2010 in 11 Dutch centers. Preoperative characteristics were compared in a benign:malignant ratio of 1:3. Malignant cases were selected from the entire cohort by using a random number list. A multivariable logistic regression prediction model was constructed to predict benign disease.Results: Of 107 patients (6.6 %) with unexpected benign disease after pancreatoduodenectomy, 86 fulfilled the inclusion criteria and were compared with 258 patients with (pre)malignant disease. Patients with benign disease presented more often with pain (56 vs. 38 %; P = 0.004), but less frequently with jaundice (60 vs. 80 %; P Conclusions: Nearly 7 % of patients undergoing pancreatoduodenectomy for suspected malignancy were ultimately diagnosed with benign disease. Although some preoperative clinical and imaging characteristics might indicate absence of malignancy, their discriminatory value is insufficient for clinical use.
AB - Background: Preoperative differentiation between malignant and benign pancreatic tumors can be difficult. Consequently, a proportion of patients undergoing pancreatoduodenectomy for suspected malignancy will ultimately have benign disease. The aim of this study was to compare preoperative clinical and diagnostic characteristics of patients with unexpected benign disease after pancreatoduodenectomy with those of patients with confirmed (pre)malignant disease.Methods: We performed a multicenter retrospective cohort study in 1,629 consecutive patients undergoing pancreatoduodenectomy for suspected malignancy between 2003 and 2010 in 11 Dutch centers. Preoperative characteristics were compared in a benign:malignant ratio of 1:3. Malignant cases were selected from the entire cohort by using a random number list. A multivariable logistic regression prediction model was constructed to predict benign disease.Results: Of 107 patients (6.6 %) with unexpected benign disease after pancreatoduodenectomy, 86 fulfilled the inclusion criteria and were compared with 258 patients with (pre)malignant disease. Patients with benign disease presented more often with pain (56 vs. 38 %; P = 0.004), but less frequently with jaundice (60 vs. 80 %; P Conclusions: Nearly 7 % of patients undergoing pancreatoduodenectomy for suspected malignancy were ultimately diagnosed with benign disease. Although some preoperative clinical and imaging characteristics might indicate absence of malignancy, their discriminatory value is insufficient for clinical use.
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U2 - 10.1245/s10434-014-3810-7
DO - 10.1245/s10434-014-3810-7
M3 - Article
C2 - 24871781
AN - SCOPUS:84918778809
SN - 1068-9265
VL - 21
SP - 3999
EP - 4006
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 12
ER -