Reply to letter to the editor “Re: Identification of Preoperative Risk Factors for Poor Survival in Patients with Resectable Pancreatic Cancer Treated with Upfront Surgery”

Preoperative biliary drainage is commonly performed in Japan for patients with cancer of the pancreatic head accompanied by obstructive jaundice due to concerns about liver dysfunction, susceptibility to infection, and hemorrhagic tendency. Therefore, biliary drainage was performed for all patients with preoperative obstructive jaundice in this study. Given the purpose of identifying preoperative risk factors for poor prognosis, separate evaluation of cancers of the pancreatic head versus body/tail might have decreased the statistical power because of the small number of eligible patients. Therefore, we did not separate data based on tumor location in this study. Since examining Lewis antigen status for all patients with pancreatic cancer is impractical, we stratified patients by CA19-9 value without including information about Lewis antigen status. Only 150 (56%) patients were followed for 5 years in this study, so long-term analysis might have had insufficient statistical power. Future studies involving larger numbers of patients with long-term (5 years) follow-up data are required to enhance the results of this study. Since we focused only on preoperative factors in this study , we did not exclude any patients based on information available only after surgery.
Source: Digestive Surgery - Category: Surgery Source Type: research