Oncological Outcomes of Open Versus Minimally Invasive Surgery for Ductal Adenocarcinomas of Pancreatic Head: A Propensity Score Matching Analysis.

IF 2.8 4区 医学 Q2 ONCOLOGY
Alessandro Giani, Michele Mazzola, Michele Paterno, Andrea Zironda, Pietro Calcagno, Emma Zuppi, Paolo De Martini, Giovanni Ferrari
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引用次数: 0

Abstract

Background: Minimally invasive pancreatic resections (MIPRs) have been shown to be safe and feasible, but there is still a lack of high-level evidence on oncological outcomes for cephalic pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to compare the oncological outcomes of patients undergoing MIPR and open pancreatic resection (OPR) for pancreatic head cancer in a single high-volume center.

Methods: Data from a prospectively collected database of patients who underwent radical-intent surgery for resectable and borderline resectable PDAC of the head at our institution between January 2013 and May 2023 were retrieved and analyzed, comparing the surgical and oncological outcomes of MIPR and OPR, using a propensity score matching analysis.

Results: In the study period, 220 patients were selected. After matching, a total of 81 MIPRs and 81 OPRs were compared. No difference was found regarding R0 rate (OPR 83.9% vs. MIPR 74.1%, p = 0.122). Median overall survival (24 and 31 months for the OPR and MIPR groups, respectively; log rank p = 0.665) and disease-free survival (12 and 21 months for the OPR and MIPR groups, respectively; log rank p = 0.118) did not differ between the groups. The MIPR group was associated with a greater number of harvested lymph nodes (22 vs. 16, p = 0.0008), longer operative time (565 vs. 420 min, p < 0.0001), and shorter length of stay (12 vs. 18 days; p = 0.0001). No differences between the groups were found regarding all other postoperative and pathological outcomes.

Conclusions: Regarding oncological outcomes, MIPR appeared to be comparable to OPR for treating patients with PDAC of the head. Despite an increased operative time, MIPR was associated with a greater number of LNs harvested and a shorter length of stay.

胰头导管腺癌开放手术与微创手术的肿瘤学结果:倾向得分匹配分析。
背景:微创胰腺切除术(MIPR)已被证明是安全可行的,但目前仍缺乏有关头端胰腺导管腺癌(PDAC)肿瘤治疗效果的高级别证据。本研究的目的是比较在单个高容量中心接受 MIPR 和开放性胰腺切除术(OPR)治疗胰头癌患者的肿瘤治疗效果:方法:检索并分析我院2013年1月至2023年5月期间因头部可切除和边缘可切除PDAC而接受根治性手术的患者的前瞻性数据库数据,采用倾向评分匹配分析法比较MIPR和OPR的手术和肿瘤预后:研究期间共选择了220例患者。结果:在研究期间,共选择了 220 名患者,经过匹配后,共比较了 81 例 MIPR 和 81 例 OPR。R0率方面没有发现差异(OPR 83.9% vs. MIPR 74.1%,p = 0.122)。两组的中位总生存期(OPR 组和 MIPR 组分别为 24 个月和 31 个月;对数秩 p = 0.665)和无病生存期(OPR 组和 MIPR 组分别为 12 个月和 21 个月;对数秩 p = 0.118)没有差异。MIPR 组的淋巴结切除数量更多(22 对 16,p = 0.0008),手术时间更长(565 对 420 分钟,p < 0.0001),住院时间更短(12 对 18 天,p = 0.0001)。在所有其他术后和病理结果方面,两组之间没有发现差异:结论:就肿瘤结果而言,MIPR治疗头部PDAC患者的效果似乎与OPR相当。尽管手术时间增加,但MIPR收获的LN数量更多,住院时间更短。
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来源期刊
Current oncology
Current oncology ONCOLOGY-
CiteScore
3.30
自引率
7.70%
发文量
664
审稿时长
1 months
期刊介绍: Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.
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