Temporal trends in outcomes with pancreatoduodenectomy for pancreatic and periampullary cancers in Sweden

Pancreatoduodenectomy is the only curative treatment for cancers of the pancreas and periampullary region, but is associated with considerable operative complications and uncertain prognosis. A retrospective analysis of all patients in Sweden with pancreatic or periampullary cancer treated with pancreatoduodenectomy from 1964 to 2016 (n=5923) investigated temporal trends in outcomes. Postoperative deaths declined fron 17.2% in the 1960s to 1.6% in the period from 2010-2016. For all cancer types, disease-free survival improved substantially over time. Between 2010 and 2016, 5-year survival was 29.0% (95% CI 25.5-33.0) for pancreatic cancer, 71.2% (62.9-80.5) for duodenal cancer, 30.8% (23.0-41.3) for bile duct cancer, and 62.7% (55.5-70.8) for duodenal papilla cancer. The authors conclude that there was a continuous and substantial improvement over time in outcomes of pancreatoduodenectomy for cancer.