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Abstract
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Background and Aims Retrospective studies have found an association between epidural analgesia and prolonged survival in patients undergoing primary surgery for solid tumor malignancies (1). There is a paucity of high-quality data in the literature regarding the impact of epidural analgesia on the survival of patients undergoing Whipple procedures for pancreatic cancer. One study of patients who underwent Whipple procedures with and without epidurals found that while epidural analgesia was associated with lower rates of infectious and pulmonary complications, there was no difference in 30 and 90 day mortality (2). However, long-term survival was not measured.
Methods We obtained IRB approval on 2/17/2021. Inclusion criteria: pancreatic cancer diagnosis code, Whipple procedure (pancreaticoduodenectomy) CPT code, located at UNC Hospitals from 2014 to 2019. Exclusion criteria: diagnosis code other than pancreatic cancer following surgery, intra-operatively or immediately post-operative death. A retrospective chart review was then conducted on a dataset from UNC’s electronic medical records, Microsoft Excel was used to process the data.
Results 108 patients were analyzed, 95 with epidurals and 13 without. Demographic traits were similar between the two groups (Table 1). The average post-operative survival time for patients who received an epidural was 1108.8 days (SD 756.6). The average post-operative survival time for patients without an epidural was 1022.0 days (SD 755.6), P-value 0.98 (Figure 1).
Conclusions Despite a trend toward longer survival for patients with pancreatic cancer who underwent a Whipple procedure with an epidural, differences in 5 year survival rates between the two groups was not statistically significant.
The demographic data for the patients with pancreatic cancer who underwent pancreaticoduodenectomy both with and with out epidurals
Survival rate for patients with epidurals compared to those without epidurals