Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1663-1672
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1663
Radiation therapy prior to a pancreaticoduodenectomy for adenocarcinoma is associated with longer operative times and higher blood loss
Krist Aploks, Minha Kim, Stephanie Stroever, Alexander Ostapenko, Young Bo Sim, Ashwinkumar Sooriyakumar, Arash Rahimi-Ardabily, Ramanathan Seshadri, Xiang Da Dong
Krist Aploks, Minha Kim, Alexander Ostapenko, Young Bo Sim, Ashwinkumar Sooriyakumar, Arash Rahimi-Ardabily, Department of General Surgery, Danbury Hospital, Danbury, CT 06810, United States
Stephanie Stroever, Department of Research and Innovation, Nuvance Health, Danbury, CT 06810, United States
Ramanathan Seshadri, Xiang Da Dong, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, Danbury, CT 06810, United States
Author contributions: Aploks K, Kim M, Ostapenko A, Dong XD, and Seshadri R contributed to the conceptualization of the project; Aploks K, Stroever S, Kim M, Ostapenko A, Dong XD, and Seshadri R contributed to the methodology and validation of the data; Stroever S conducted the formal statistical analyses; Aploks K, Kim M, Sim YB, and Sooriyakumar A prepared the original manuscript; Aploks K, Kim M, Ostapenko A, Sim YB, Sooriyakumar A, Rahimi-Ardabily A, Dong XD, and Seshadri R contributed to the final draft revision and editing; Dong XD and Seshadri R supervised the project.
Institutional review board statement: Ethical review and approval were waived for this study since the data used was de-identified and obtained from a participant use data file.
Informed consent statement: This study was a retrospective review that utilized only de-identified patient data from National Cancer Database. Given this fact, no signed informed consent is needed.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Data was obtained with permission from the American College of Surgeon's National Cancer Database. NSQIP data can be obtained by visiting https://www.facs.org/quality-programs/data-and-registries/acs-nsqip/.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang Da Dong, FACS, MD, Chief Doctor, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, 95 Locust Avenue, Danbury, CT 06810, United States. eric.dong@nuvancehealth.org
Received: March 29, 2023
Peer-review started: March 29, 2023
First decision: April 26, 2023
Revised: May 12, 2023
Accepted: June 12, 2023
Article in press: June 12, 2023
Published online: August 27, 2023
Processing time: 148 Days and 21.6 Hours
Core Tip

Core Tip: In this retrospective study, we used a national database to investigate the impact that neoadjuvant radiotherapy has on intraoperative and 30-d post-operative outcomes among patients undergoing surgical resection for pancreatic adenocarcinoma. We found that neoadjuvant radiotherapy was associated with longer operative times and the more frequent need for perioperative blood transfusions, but not with increased 30-d mortality. Neoadjuvant radiotherapy was also associated with a lower number of organ space infections and post-operative pancreatic fistula formation. Taken together, the results highlight the challenges that surgeons may face when operating in previously irradiated fields.