Five-year recurrence/survival after pancreatoduodenectomy for pancreatic adenocarcinoma: does pre-existing diabetes matter? Results from the Recurrence After Whipple's (RAW) study.

Rajagopalan, A.; Aroori, S.; Russell, TB.; Labib, PL.; Ausania, F.; Pando, E.; Roberts, KJ.; Kausar, A.; Mavroeidis, VK.; Marangoni, G.; Thomasset, SC.; Frampton, AE.; Lykoudis, P.; Maglione, M.; Alhaboob, N.; Bari, H.; Smith, AM.; Spalding, D.; Srinivasan, P.; Davidson, BR.; Bhogal, RH.; Dominguez, I.; Thakkar, R.; Gomez, D.; Silva, MA.; Lapolla, P.; Mingoli, A.; Porcu, A.; Shah, NS.; Hamady, ZZR.; Al-Sarrieh, B.; Serrablo, A.; Croagh, D.

Five-year recurrence/survival after pancreatoduodenectomy for pancreatic adenocarcinoma: does pre-existing diabetes matter? Results from the Recurrence After Whipple's (RAW) study.

All Authors

Rajagopalan, A.

Aroori, S.

Russell, TB.

Labib, PL.

Ausania, F.

Pando, E.

Roberts, KJ.

Kausar, A.

Mavroeidis, VK.

Marangoni, G.

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LTHT Author

Smith, Andrew

LTHT Department

Hepatobiliary Surgery

Publication Date

2024

Item Type

Journal Article
Multicenter Study

Abstract

BACKGROUND: Diabetes mellitus (DM) has a complex relationship with pancreatic cancer. This study examines the impact of preoperative DM, both recent-onset and pre-existing, on long-term outcomes following pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). METHODS: Data were extracted from the Recurrence After Whipple's (RAW) study, a multi-centre cohort of PD for pancreatic head malignancy (2012-2015). Recurrence and five-year survival rates of patients with DM were compared to those without, and subgroup analysis performed to compare patients with recent-onset DM (less than one year) to patients with established DM. RESULTS: Out of 758 patients included, 187 (24.7%) had DM, of whom, 47 of the 187 (25.1%) had recent-onset DM. There was no difference in the rate of postoperative pancreatic fistula (DM: 5.9% vs no DM 9.8%; p = 0.11), five-year survival (DM: 24.1% vs no DM: 22.9%; p = 0.77) or five-year recurrence (DM: 71.7% vs no DM: 67.4%; p = 0.32). There was also no difference between patients with recent-onset DM and patients with established DM in postoperative outcomes, recurrence, or survival. CONCLUSION: We found no difference in five-year recurrence and survival between diabetic patients and those without diabetes. Patients with pre-existing DM should be evaluated for PD on a comparable basis to non-diabetic patients.