TY - JOUR
T1 - Preoperative Endoscopic Retrograde Cholangiopancreatography Is Not Associated With Increased Pancreatic Cancer Mortality
AU - Rustgi, Sheila D.
AU - Amin, Sunil
AU - Yang, Anthony
AU - Kim, Michelle K.
AU - Nagula, Satish
AU - Kumta, Nikhil A.
AU - DiMaio, Christopher J.
AU - Boffetta, Paolo
AU - Lucas, Aimee L.
N1 - Funding Information:
Funding Aimee L. Lucas was supported by American Cancer Society (ACS) 129387-MRSG-16-015-01-CPHPS. Original article Pancreas, biliary tract, and liver
Publisher Copyright:
© 2019 AGA Institute
PY - 2019/7
Y1 - 2019/7
N2 - Background & Aims: Endoscopic retrograde cholangiopancreatography (ERCP) before surgery for pancreatic cancer has been associated with infectious complications after surgery. Little is known about the effects of preoperative ERCP on the survival of patients with pancreatic cancer. We investigated whether ERCP before surgery affects overall survival, after controlling for confounding factors. Methods: We used Surveillance, Epidemiology, and End Results (SEER) and linked Medicare claims data to identify patients older than 65 years with cancer localized to the head of the pancreas, from 2000 through 2011. We used inverse propensity-weighted Cox proportional hazard models to assess the effects of ERCP on the survival of patients who underwent surgery for pancreatic cancer. Results: Among 16,670 patients with cancer of the head of the pancreas, 2890 (17.3%) underwent surgical resection; 1864 (64.5%) of these patients received preoperative ERCP. After we adjusted for confounders, we found that patients who received preoperative ERCP did not have an increased risk of death compared with patients who underwent resection alone (hazard ratio, 1.02; 95% CI, 0.96–1.08). Conclusions: Patients with pancreatic cancer who underwent ERCP before surgery did not have an increased risk of death compared with patients who proceeded directly to surgery. Studies are needed to identify subsets of patients who may benefit from this procedure.
AB - Background & Aims: Endoscopic retrograde cholangiopancreatography (ERCP) before surgery for pancreatic cancer has been associated with infectious complications after surgery. Little is known about the effects of preoperative ERCP on the survival of patients with pancreatic cancer. We investigated whether ERCP before surgery affects overall survival, after controlling for confounding factors. Methods: We used Surveillance, Epidemiology, and End Results (SEER) and linked Medicare claims data to identify patients older than 65 years with cancer localized to the head of the pancreas, from 2000 through 2011. We used inverse propensity-weighted Cox proportional hazard models to assess the effects of ERCP on the survival of patients who underwent surgery for pancreatic cancer. Results: Among 16,670 patients with cancer of the head of the pancreas, 2890 (17.3%) underwent surgical resection; 1864 (64.5%) of these patients received preoperative ERCP. After we adjusted for confounders, we found that patients who received preoperative ERCP did not have an increased risk of death compared with patients who underwent resection alone (hazard ratio, 1.02; 95% CI, 0.96–1.08). Conclusions: Patients with pancreatic cancer who underwent ERCP before surgery did not have an increased risk of death compared with patients who proceeded directly to surgery. Studies are needed to identify subsets of patients who may benefit from this procedure.
KW - Obstructive Jaundice
KW - Outcome
KW - Pancreatic Adenocarcinoma
KW - Stent
UR - http://www.scopus.com/inward/record.url?scp=85067293831&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2018.11.056
DO - 10.1016/j.cgh.2018.11.056
M3 - Article
C2 - 30529734
AN - SCOPUS:85067293831
SN - 1542-3565
VL - 17
SP - 1580-1586.e4
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 8
ER -