Evidence map›Paper›PMID 42263218›Full record

ArticleBJS open2026

Impact of preoperative radiotherapy on the risk of postpancreatectomy haemorrhage and major morbidity after resection of pancreatic adenocarcinoma including arterial divestment or arterial resection.

Thomas F Stoop, Freek R van 't Land, Leonard W F Seelen, Mahsoem Ali, Ahmer Sultan, Ammar A Javed, Casper H J van Eijck, Cornelius A Thiels, D Brock Hewitt, Ernesto Sparrelid and 28 more

Abstract read
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Article in BJS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

38 authors.

Thomas F StoopAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Freek R van 't LandDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.ORCID 0009-0009-1990-9672
Leonard W F SeelenDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center/St. Antonius Hospital Nieuwegein, Utrecht/Nieuwegein, the Netherlands.
Mahsoem AliCancer Center Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0002-0511-6323
Ahmer SultanDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0009-0006-8320-1343
Ammar A JavedDivision of Surgical Oncology, Department of Surgery, New York University Medical Center, New York City, New York, USA.
Casper H J van EijckDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Cornelius A ThielsDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
D Brock HewittDivision of Surgical Oncology, Department of Surgery, New York University Medical Center, New York City, New York, USA.
Ernesto SparrelidDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
Faik G UzunogluDepartment of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
O H Fiete GehrischDepartment of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Freek DaamsCancer Center Amsterdam, Amsterdam, the Netherlands.
Hiroyuki IshidaDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Hjalmar C van SantvoortDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center/St. Antonius Hospital Nieuwegein, Utrecht/Nieuwegein, the Netherlands.
I Quintus MolenaarDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center/St. Antonius Hospital Nieuwegein, Utrecht/Nieuwegein, the Netherlands.
Jennifer L LeitingDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Joris I ErdmannAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.ORCID 0000-0001-8233-1505
Marie CappelleDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Michael GinesiniDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Michael L KendrickDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Niccolo NapoliDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Olivier R BuschAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.ORCID 0000-0001-9605-6831
Oskar FranklinDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.ORCID 0000-0002-3777-6887
Poya GhorbaniDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
Richard D SchulickDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Rimon DankhaDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
Roeland F de WildeDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Thilo WelschDepartment of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Wouter Te RieleDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center/St. Antonius Hospital Nieuwegein, Utrecht/Nieuwegein, the Netherlands.
Christopher L WolfgangDivision of Surgical Oncology, Department of Surgery, New York University Medical Center, New York City, New York, USA.
Marc G BesselinkAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.ORCID 0000-0003-2650-9350
Bas Groot KoerkampDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.ORCID 0000-0003-1917-6973
Ugo BoggiDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Mark J TrutyDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Marco Del ChiaroDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Thilo HackertDepartment of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.ORCID 0000-0002-7012-1196
International Collaboration on Advanced Pancreatic Cancer

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSome centres advocate preoperative radiotherapy in patients with pancreatic cancer and arterial involvement despite a lack of Level 1 evidence on survival benefit. Although it has been suggested that preoperative radiotherapy may increase the risk of postpancreatectomy haemorrhage (PPH) and morbidity, evidence is again lacking. This study investigated the association between preoperative radiotherapy and both PPH and major morbidity following arterial divestment/resection during pancreatic adenocarcinoma resection after chemotherapy.

methodsConsecutive patients diagnosed with pancreatic adenocarcinoma and > 180° arterial involvement who were treated with preoperative chemotherapy with or without radiotherapy followed by pancreatic resection with arterial divestment/resection were included in the study. Logistic regression analyses including propensity score-based overlap weighting were performed to investigate associations between radiotherapy and in-hospital PPH grade B/C and major morbidity, expressed as adjusted risk differences (aRDs).

resultsOverall, 246 patients undergoing pancreatic resection with arterial resection (169, 69%) or divestment (77, 31%) were included. Radiotherapy was not associated with PPH (aRD 6%; 95% confidence interval (c.i.) -3 to 14), regardless of arterial divestment (aRD 3%; 95% c.i. -5 to 11) or arterial resection (aRD 12%; 95% c.i. 1 to 23; Pinteraction = 0.189). Radiotherapy was associated with a 14% (95% c.i. 2 to 25) higher risk of major morbidity, especially after arterial resection (aRD 27%; 95% c.i. 11 to 43) compared with arterial divestment (aRD -12%; 95% c.i. -35 to 11; Pinteraction = 0.006) and after external beam radiotherapy (aRD 21%; 95% c.i. 8 to 32) compared with stereotactic body radiotherapy (aRD -12%; 95% c.i. -27 to 6; Pinteraction = 0.0001). Ninety-day mortality was increased, albeit not significantly, after preoperative radiotherapy (10 (8%) versus 3 (3%) deaths with versus without preoperative radiotherapy, respectively; P = 0.067).

conclusionsRadiotherapy before resection of pancreatic cancer with > 180° arterial involvement was associated with an increased risk of postoperative major morbidity when arterial resection, but not arterial divestment, was performed. This risk should be taken into account when considering preoperative radiotherapy in patients who may require arterial resection.

Indexed as

AdenocarcinomaPancreatectomyPancreatic NeoplasmsPostoperative HemorrhageAgedFemaleHumansMaleMiddle AgedPancreasPreoperative CarePropensity ScoreRetrospective StudiesRisk Factorsadvanced pancreatic cancer surgerypostoperative complications

Identifiers

PMID42263218
PMCPMC13247997

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