PDAC: dexamethasone during Whipple procedure tied to better OS

  • Sandini M & al.
  • Ann Surg Oncol
  • 8 Oct 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • A single, intraoperative dose of dexamethasone significantly reduced infectious complications after pancreaticoduodenectomy (PD, also known as a Whipple procedure), and was associated with a significant OS advantage in patients with pancreatic ductal adenocarcinoma (PDAC).

Why this matters

  • The effect of dexamethasone and other corticosteroids on healing after PD was unclear.

Study design

  • 679 patients with pancreatic cancer underwent PD with (n=117) or without (n=562) intraoperative dexamethasone.
  • Funding: None disclosed.

Key results

  • Rate of overall complications was similar between groups (59.0% in dexamethasone group vs 62.8% in control group; P=.346).
  • Dexamethasone was associated with both significantly fewer infectious complications (18.8% vs 28.5%; P=.032) and a trend toward lower incidence of postoperative sepsis that failed to achieve significance (2.6% vs 7.3%; P=.059).
  • Median OS was significantly higher with dexamethasone (46 vs 22 months; P=.017).
  • In multivariate analysis, dexamethasone was significantly associated with better OS (HR, 0.57; 95% CI, 0.37-0.87).

Limitations

  • Retrospective study.
  • Only

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