Risk-stratified analysis of pasireotide for patients undergoing pancreatectomy

June S. Peng, Daniel Joyce, Maureen Brady, Adrienne Groman, Kristopher Attwood, Boris Kuvshinoff, Steven N. Hochwald, Moshim Kukar

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Pasireotide was shown in a randomized trial to decrease the rate of postoperative pancreatic fistula (POPF). However, retrospective series from other centers have failed to confirm these results. Methods: Patients who underwent pancreatoduodenectomy or distal pancreatectomy between January 2014 and February 2019 were included. Patients treated after November 2016 routinely received pasireotide and were compared to a retrospective cohort. Multivariate analysis was performed for the outcome of clinically relevant POPF (CR-POPF), with stratification by fistula risk score (FRS). Results: Ninety-nine of 300 patients received pasireotide. The distribution of high, intermediate, low, and negligible risk patients by FRS was comparable (P =.487). There were similar rates of CR-POPF (19.2% pasireotide vs 14.9% control, P =.347) and percutaneous drainage (12.1% vs 10.0%, P =.567), with greater median number of drain days in the pasireotide group (6 vs 4 days, P <.001). Multivariate modeling for CR-POPF showed no correlation with operation or pasireotide use. Adjustment with propensity weighted models for high (OR, 1.02, 95% CI, 0.45-2.29) and intermediate (OR, 1.02, CI, 0.57-1.81) risk groups showed no correlation of pasireotide with reduction in CR-POPF. Conclusions: Pasireotide administration after pancreatectomy was not associated with a decrease in CR-POPF, even when patients were stratified by FRS.

Original languageEnglish (US)
Pages (from-to)195-203
Number of pages9
JournalJournal of Surgical Oncology
Volume122
Issue number2
DOIs
StatePublished - Aug 1 2020

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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    Peng, J. S., Joyce, D., Brady, M., Groman, A., Attwood, K., Kuvshinoff, B., Hochwald, S. N., & Kukar, M. (2020). Risk-stratified analysis of pasireotide for patients undergoing pancreatectomy. Journal of Surgical Oncology, 122(2), 195-203. https://doi.org/10.1002/jso.25949