Pancreatic Cancer Resection, a Single Center Experience
Bibliographic record
Abstract
Purpose: Pancreatic cancer has a poor prognosis with surgical resection being the only available therapy offering a chance for long-term survival. Over the past 20 years, the literature has documented a dramatic decrease in the postoperative morbidity and mortality rates associated with pancreatic resections with overall 5-year survival reported up to 30%. The aim of this study is to describe our local experience. Methods: Between 2000 and 2010, 78 patients had a pancreatic tumor resection in CHUS hospital Hôtel-Dieu and Fleurimont. We retrospectively analyzed 34 patients who had a pancreatic resection for adenocarcinoma and 44 patients who had a pancreatic resection for other pancreatic tumors. The survival was estimated with Kaplan-Meier plots. Results: The mean age of patients was 63 years. Nine surgeons did these 78 resections. 94% of patients had an abdominal CAT scan and 53% had an endoscopic ultrasound evaluation preoperatively. Whipple procedure was performed on 61 patients, 11 had distal pancreatectomy and 6 had a total pancreatectomy. Of patients with adenocarcinoma, 62% had an R0 resection and 57% had regional lymph node metastasis on pathological examination. Postoperative 60-day mortality for all patients was 7.7% (6/78). Significant postoperative morbidity was observed in 60% of patients and 9% had a pancreatic fistula. Their median hospital stay was 26 days. Of patients with adenocarcinoma, 43% had adjuvant chemotherapy and 23% had adjuvant radiotherapy as well. The patients median survival for all tumors was 30 months and of 12.5 months for patients with pancreatic adenocarcinoma. Their 5-year survival was estimated to 44% for all tumors and 15% for the pancreatic adenocarcinoma. Conclusion: In order to improve our long-term survival, we must improve our preoperative evaluation to better identify patients with positive lymph nodes. We should reduce number of surgeons performing pancreatectomies in order to achieve more R0 resections and lower postoperative morbidity and mortality. Those strategies will hopefully allow more patients to be eligible for adjuvant therapies and improve overall survival.Figure: No Caption available.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".