Original Article
Ridho Ardhi Syaiful, Yarman Ma
Abstract
Context Surgery is the main palliative treatment of advanced periampullary cancer; however, it has high number of post-operative complication, disease recurrence, and mortality. Objective: The objective of the current study was to examine survival rate and prognostic factors of palliative surgery of advanced-stage periampullary cancer. Methods This was a retrospective cohort study. Patients included in study underwent hepaticojejunostomy and gastrojejunostomy palliative surgery in Cipto Mangunkusumo Hospital. Demographic data, pre-operative laboratory and clinical parameter, cancer spread, histopathological type, and post-operative outcome were collected from medical records from January 2015 until December 2017. One year and 30-day survival rate were analyzed with Kaplan-Meier method. One-year survival comparison, bivariate, and multivariate analysis based on patients’ characteristics was done. Results One-year survival rate of palliative surgery patients is 19 percent with median (min-max) survival 159 (2-365) days. The 30-day survival rate is 88 percent. Based on variables grouping, hemoglobin (p=0.013) and American Society of Anesthesiologists Classification (ASA classification) (p=0.001) showed significant different of survival estimation statistically. Conclusions One-year survival rate of palliative surgery of advanced stage periampullary cancer patients was low and associated with hemoglobin value and ASA classification. The 30-day mortality rate of palliative surgery was low, it indicates that palliative surgery is a safe procedure.