Outcomes after distal pancreatectomy with celiac axis resection for pancreatic cancer: a Pan-European retrospective cohort study

Klompmaker, S. (Sjors); Hilst, J. (Jony) van; Gerritsen, S. (Sarah L.); Adham, M. (Mustapha); Albiol-Quer, T. (Teresa); Bassi, C. (Claudio); Berrevoet, F. (Frederik); Boggi, U. (Ugo); Busch, O. (Olivier R.); Cesaretti, M. (Manuela); Dalla-Valle, R. (Raffaele); Darnis, B. (Benjamin); De-Pastena, M. (Matteo); Del-Chiaro, M. (Marco); Grützmann, R. (Robert); Diener, M.K. (Markus K.); Dumitrascu, T. (Traian); Friess, H. (Helmut); Ivanecz, A. (Arpad); Karayiannakis, A. (Anastasios); Fusai, G.K. (Giuseppe K.); Labori, K.J. (Knut J.); Lombardo, C. (Carlo); López-Ben, S. (Santiago); Mabrut, J.Y. (Jean-Yves); Niesen, W. (Willem); Pardo, F. (Fernando); Perinel, J. (Julie); Popescu, I. (Irinel); Roeyen, G. (Geert); Sauvanet, A. (Alain); Prasad, R. (Raj); Sturesson, C. (Christian); Lesurtel, M. (Mickael); Kleeff, J. (Jorg); Salvia, R. (Roberto); Besselink, M.G. (Marc G.)

Keywords:

Western multicenter studies
Celiac axis resection
Appleby procedure
Pancreatic cancer

Issue Date:

2018

Publisher:

Springer Science

ISSN:

1068-9265

Note:

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Citation:

Klompmaker, S. (Sjors); Hilst, J. (Jony) van; Gerritsen, S. (Sarah L.); et al. "Outcomes after distal pancreatectomy with celiac axis resection for pancreatic cancer: a Pan-European retrospective cohort study". Annals of surgical oncology. 25 (5), 2018, 1440 - 1447

Abstract

Background: Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). Methods: Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival. Secondary endpoints were radicality (R0-resection), 90-day mortality, major morbidity, and pancreatic fistulae (grade B/C). Results: We included 68 patients from 20 hospitals in 12 countries. Postoperatively, 53% of patients had R0-resection, 25% major morbidity, 21% an ISGPS grade B/C pancreatic fistula, and 16% mortality. In total, 82% received (neo-)adjuvant chemotherapy and median overall survival in 62 patients with pancreatic ductal adenocarcinoma patients was 18 months (CI 10-37). We observed no impact of PHAE on ischemic complications. Conclusions: DP-CAR combined with chemotherapy for locally advanced pancreatic cancer is associated with acceptable overall survival. The 90-day mortality is too high and should be reduced. Future studies should investigate to what extent increasing surgical volume or better patient selection can improve outcomes.

URI:

https://hdl.handle.net/10171/65535

DOI:

10.1245/s10434-018-6391-z

Appears in Collections:

DA - CUN - Cirugía general y digestiva - Artículos de revista

Files in This Item: