One-quarter of pancreaticoduodenectomies may be futile

A retrospective analysis of 66,326 patients revealed that 25.3% of pancreaticoduodenectomies (PD) for non-metastatic pancreatic ductal adenocarcinoma were futile, defined as death within 12 months. Factors increasing futility included macroscopically positive margins, poor tumor differentiation, and N2 nodal stage. Conversely, systemic therapy, radiation, and neoadjuvant therapy reduced the likelihood of futility. In the subgroup receiving neoadjuvant therapy, a longer diagnosis-to-surgery interval correlated with lower futility rates.