{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T18:52:48Z","timestamp":1761418368087,"version":"3.40.4"},"reference-count":56,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T00:00:00Z","timestamp":1104537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T00:00:00Z","timestamp":1104537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Surg"],"published-print":{"date-parts":[[2005]]},"abstract":"<jats:p>&lt;i&gt;Background\/Aims:&lt;\/i&gt; The influence of type of surgery and occurrence of post-operative complications on survival following adjuvant therapy for pancreatic cancer are uncertain. &lt;i&gt;Methods:&lt;\/i&gt; Cox proportional hazard modelling was used to investigate the influence of type of surgery and the presence of complications on survival in conjunction with clinico-pathological variables in the 550 patients of the ESPAC-1 adjuvant randomized controlled trial. &lt;i&gt;Results:&lt;\/i&gt; Standard Kausch-Whipple (KW) was performed in 282 (54%) patients, 186 (35%) had a pylorus-preserving (PP) KW, 39 (7%) had a distal pancreatectomy and 21 (4%) had a total pancreatectomy. Post-operative complications were reported in 140 (27%) patients. PP-KW patients survived longer with a median (95% CI) survival of 19.9 (17.3, 23.1) months compared to 14.8 (13.0, 16.7) for KW patients (\u03c7&lt;sup&gt;2&lt;\/sup&gt;&lt;sub&gt;LR&lt;\/sub&gt; = 15.1, p &lt; 0.001). KW patients were more likely however to have R1 margins (67 (24%) vs. 29 (16%), \u03c7&lt;sup&gt;2&lt;\/sup&gt; = 4.59, p = 0.032), poorly differentiated tumours (70 (26%) vs. 19 (10%), \u03c7&lt;sup&gt;2&lt;\/sup&gt; = 18.65, p &lt; 0.001) and positive lymph nodes (165 (60%) vs. 81 (44%), \u03c7&lt;sup&gt;2&lt;\/sup&gt; = 11.32, p &lt; 0.001). Post-operative complications did not significantly affect survival. Independent prognostic factors were tumour grade, nodal status and tumour size but not type of surgery or post-operative complications. There was a survival benefit for chemotherapy irrespective of the type of surgery or post-operative complications. &lt;i&gt;Conclusions:&lt;\/i&gt; The KW and PP-KW procedures did not significantly influence the hazard of death in the presence of tumour staging, demonstrating that ESPAC-1 surgeons showed good judgement in their choice of operation. Post-operative complications did not adversely affect the survival benefit from adjuvant chemotherapy.<\/jats:p>","DOI":"10.1159\/000089771","type":"journal-article","created":{"date-parts":[[2006,2,2]],"date-time":"2006-02-02T09:34:37Z","timestamp":1138872877000},"page":"353-363","source":"Crossref","is-referenced-by-count":58,"title":["Influence of Surgical Resection and Post-Operative Complications on Survival following Adjuvant Treatment for Pancreatic Cancer in the ESPAC-1 Randomized Controlled Trial"],"prefix":"10.1159","volume":"22","author":[{"given":"C.","family":"Bassi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.D.","family":"Stocken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Olah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Friess","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Buckels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Hickey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Dervenis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.A.","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Deakin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Carter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Ghaneh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.P.","family":"Neoptolemos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.W.","family":"B\u00fcchler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2006,2,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016%2FS0959-8049%2801%2900267-2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.1800820137"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3322%2Fcanjclin.53.1.5"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1365-2168.1997.00504.x"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJMsa012337"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016%2FS1072-7515%2899%2900075-7"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.4794"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016%2FS0002-9610%2805%2980406-4"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199501000-00007"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199705000-00018"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1159%2F000050193"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.4484"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002%2F1097-0142%2819870615%2959%3A12%3C2006%3A%3AAID-CNCR2820591206%3E3.0.CO%3B2-B"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199912000-00006"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002%2Fcncr.10831"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1093%2Fannonc%2Fmdg207"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1365-2036.2003.01781.x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016%2FS0360-3016%2899%2900107-8"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016%2FS0360-3016%2800%2900774-4"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016%2FS0002-9610%2803%2900051-5"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002%2F1097-0142%2820000715%2989%3A2%3C314%3A%3AAID-CNCR16%3E3.0.CO%3B2-V"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016%2FS0140-6736%2801%2906651-X"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-200112000-00007"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJMoa032295"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007%2Fs10434-001-0123-4"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007%2FBF00294750"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002%2F%28SICI%291097-0142%2819960215%2977%3A4%3C640%3A%3AAID-CNCR9%3E3.3.CO%3B2-H"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007%2Fs002689900378"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-198808000-00014"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199810000-00007"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-200209000-00012"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1007%2Fs002689910089"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199208000-00004"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1046%2Fj.1365-2168.1999.01074.x"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1007%2Fs002689900600"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016%2FS1091-255X%2800%2980084-0"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016%2FS1091-255X%2800%2980105-5"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.1800790219"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1097%2F00000658-199812000-00009"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1002%2F1097-0215%2820001120%2989%3A6%3C469%3A%3AAID-IJC1%3E3.0.CO%3B2-L"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1158%2F1078-0432.CCR-1157-03"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1159%2F000018739"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1159%2F000018744"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1093%2Fjnci%2F85.5.365"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.2307%2F2281868"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1002%2F1097-0258%2820001015%2919%3A19%3C2657%3A%3AAID-SIM557%3E3.3.CO%3B2-V"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1002%2F1097-0142%2819940215%2973%3A4%3C1155%3A%3AAID-CNCR2820730406%3E3.0.CO%3B2-H"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.1800820340"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016%2FS0039-6060%2897%2990352-4"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1002%2F%28SICI%291097-0142%2819990201%2985%3A3%3C583%3A%3AAID-CNCR8%3E3.0.CO%3B2-J"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.4761"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.soc.2004.06.007"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1159%2F000052029"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1038%2Fsj.bjc.6602513"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1097%2F01.sla.0000143248.71964.29"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.4881"}],"container-title":["Digestive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/89771","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/89771","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:44:12Z","timestamp":1745466252000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000089771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2006,2,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000089771","archive":["Portico"],"relation":{},"ISSN":["0253-4886","1421-9883"],"issn-type":[{"type":"print","value":"0253-4886"},{"type":"electronic","value":"1421-9883"}],"subject":[],"published":{"date-parts":[[2005]]}}}