Prognostic Impact of Unplanned Total Pancreatectomy in Pancreatic Ductal Adenocarcinoma: A Retrospective Analysis.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-07-02 DOI:10.1002/jhbp.12176

Dongha Lee, Keiko Kamei, Chihoko Nobori, Yuta Yoshida, Takaaki Murase, Atsushi Takebe, Takuya Nakai, Mamoru Takenaka, Takaaki Chikugo, Ippei Matsumoto

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引用次数: 0

Abstract

Background: This study evaluated the clinical significance of an unplanned total pancreatectomy (TP) by comparing surgical outcomes of planned and unplanned TP for pancreatic ductal adenocarcinoma (PDAC).

Methods: Forty-two patients who underwent TP for PDAC between 2009 and 2020 at the Kindai University Hospital were retrospectively analyzed. We evaluated the differences in the prognosis and related factors between planned and unplanned TP, and independent prognostic factors of TP for PDAC.

Results: Twenty-three patients underwent planned TP, and 19 underwent unplanned TP. There were no significant differences in clinicopathological data between the two groups, except for microscopic vascular invasion. However, the unplanned TP group had significantly better overall survival (OS) and recurrence-free survival (RFS) times than the planned TP group. In the multivariate analysis of the prognostic factors of TP for PDAC, a planned TP and not receiving or completing postoperative adjuvant chemotherapy (AC) were independent poor prognostic factors.

Conclusion: This study supports a rigorous approach to margin clearance in TP for PDAC to achieve curative negative margins in cancer-positive pancreatic resection stumps. However, the prognosis of a planned TP for PDAC is extremely poor, and adequate preoperative and multidisciplinary treatment may be necessary to prolong the prognosis.

查看原文本刊更多论文

非计划全胰切除术对胰管腺癌预后的影响：回顾性分析。

背景：本研究通过比较计划全胰切除术与计划全胰切除术治疗胰导管腺癌（PDAC）的手术效果，评价计划外全胰切除术（TP）的临床意义。方法：回顾性分析2009年至2020年在金大大学医院接受TP治疗的42例PDAC患者。我们评估了计划TP与非计划TP的预后及相关因素的差异，以及TP对PDAC的独立预后因素。结果：计划TP患者23例，非计划TP患者19例。两组除显微血管侵犯外，临床病理资料无显著差异。然而，非计划TP组的总生存期（OS）和无复发生存期（RFS）明显优于计划TP组。在多因素分析TP对PDAC预后的影响因素中，计划TP和未接受或完成术后辅助化疗（AC）是独立的不良预后因素。结论：本研究支持一种严格的TP边缘清除方法，用于PDAC，以实现癌症阳性胰腺切除残端阴性边缘的治疗。然而，PDAC的计划TP预后非常差，可能需要充分的术前和多学科治疗来延长预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.