TY - JOUR
T1 - Risk-stratified analysis of pasireotide for patients undergoing pancreatectomy
AU - Peng, June S.
AU - Joyce, Daniel
AU - Brady, Maureen
AU - Groman, Adrienne
AU - Attwood, Kristopher
AU - Kuvshinoff, Boris
AU - Hochwald, Steven N.
AU - Kukar, Moshim
N1 - Funding Information:
This study was supported by Roswell Park Cancer Institute and National Institutes of Health (grant no: P30CA016056).
Publisher Copyright:
© 2020 Wiley Periodicals LLC
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background and Objectives: Pasireotide was shown in a randomized trial to decrease the rate of postoperative pancreatic fistula (POPF). However, retrospective series from other centers have failed to confirm these results. Methods: Patients who underwent pancreatoduodenectomy or distal pancreatectomy between January 2014 and February 2019 were included. Patients treated after November 2016 routinely received pasireotide and were compared to a retrospective cohort. Multivariate analysis was performed for the outcome of clinically relevant POPF (CR-POPF), with stratification by fistula risk score (FRS). Results: Ninety-nine of 300 patients received pasireotide. The distribution of high, intermediate, low, and negligible risk patients by FRS was comparable (P =.487). There were similar rates of CR-POPF (19.2% pasireotide vs 14.9% control, P =.347) and percutaneous drainage (12.1% vs 10.0%, P =.567), with greater median number of drain days in the pasireotide group (6 vs 4 days, P <.001). Multivariate modeling for CR-POPF showed no correlation with operation or pasireotide use. Adjustment with propensity weighted models for high (OR, 1.02, 95% CI, 0.45-2.29) and intermediate (OR, 1.02, CI, 0.57-1.81) risk groups showed no correlation of pasireotide with reduction in CR-POPF. Conclusions: Pasireotide administration after pancreatectomy was not associated with a decrease in CR-POPF, even when patients were stratified by FRS.
AB - Background and Objectives: Pasireotide was shown in a randomized trial to decrease the rate of postoperative pancreatic fistula (POPF). However, retrospective series from other centers have failed to confirm these results. Methods: Patients who underwent pancreatoduodenectomy or distal pancreatectomy between January 2014 and February 2019 were included. Patients treated after November 2016 routinely received pasireotide and were compared to a retrospective cohort. Multivariate analysis was performed for the outcome of clinically relevant POPF (CR-POPF), with stratification by fistula risk score (FRS). Results: Ninety-nine of 300 patients received pasireotide. The distribution of high, intermediate, low, and negligible risk patients by FRS was comparable (P =.487). There were similar rates of CR-POPF (19.2% pasireotide vs 14.9% control, P =.347) and percutaneous drainage (12.1% vs 10.0%, P =.567), with greater median number of drain days in the pasireotide group (6 vs 4 days, P <.001). Multivariate modeling for CR-POPF showed no correlation with operation or pasireotide use. Adjustment with propensity weighted models for high (OR, 1.02, 95% CI, 0.45-2.29) and intermediate (OR, 1.02, CI, 0.57-1.81) risk groups showed no correlation of pasireotide with reduction in CR-POPF. Conclusions: Pasireotide administration after pancreatectomy was not associated with a decrease in CR-POPF, even when patients were stratified by FRS.
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U2 - 10.1002/jso.25949
DO - 10.1002/jso.25949
M3 - Article
C2 - 32474957
AN - SCOPUS:85085602533
SN - 0022-4790
VL - 122
SP - 195
EP - 203
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 2
ER -