Aborted oncologic surgery in digestive tract neoplasms: preliminary results from a tertiary referral center

Abstract

Introduction: Surgery is the cornerstone of treatment for digestive tract neoplasms. The term aborted oncologic surgery is currently used to describe the inability to complete a planned curative surgical procedure due to intraoperative findings indicating advanced disease extent.

Objective: To analyze the incidence, causes, morbidity, mortality, and survival of aborted oncologic surgery in patients with diges-tive tract neoplasms. Materials and

Methods: A retrospective observational study including patients over 18 years of age with esophagogastric and hepatobiliopancreatic neoplasms who underwent surgical intervention between 2017 and 2023 at a tertiary care hospital. Demographic variables, tumor type and stage, preoperative diagnostic imaging, intraoperative findings, postoperative complications, mortality, and overall survival were analyzed.

Results: A total of 788 patients were included, of whom 51 (6.47%) underwent aborted oncologic surgery. Hepatobiliopancreatic neoplasms accounted for 86.3% of cases. The main causes were previously undetected metastases (49.0%) and unresectable locoregional disease (15.5%). The tumors with the highest rates of aborted surgery were pancreatic adenocarcinoma (33.3%) and cholangiocarcinoma (31.4%). Major morbidity was 15.6%, and in-hospital and 30-day mortality was 3.9%. Median overall survival was 10 months, with a 5-year survival rate of 15.7%.

Discussion: Despite advances in preoperative staging, aborted oncologic surgery remains a clinically relevant event, associated with high morbidity and poor prognosis.

Conclusion: Aborted oncologic surgery in digestive tract neo-plasms is associated with poor survival and highlights the need to optimize preoperative patient selection and to strengthen multidisciplinary postoperative management.