Annals of Gastroenterological Surgery最新文献

{"title":"Laparoscopic median arcuate ligament release using an anterior approach for median arcuate ligament syndrome","authors":"Koji Kubota,&nbsp;Akira Shimizu,&nbsp;Tsuyoshi Notake,&nbsp;Satoshi Nakamura,&nbsp;Yuji Soejima","doi":"10.1002/ags3.12858","DOIUrl":"10.1002/ags3.12858","url":null,"abstract":"<p>Median arcuate ligament syndrome (MALS) is a rare condition characterized by nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Furthermore, the development and rupture of pancreaticoduodenal artery aneurysms pose a potentially fatal risk. Median arcuate ligament release (MALR) is useful in the treatment of MALS, with most procedures performed laparoscopically. However, detailed descriptions of laparoscopic MALR (lap-MALR) procedures are rare. In this study, we performed lap-MALR via an anterior approach with dissection of the right lateral wall of the celiac artery (CA). For optimal visualization of the right side of the CA, the right branch of the inferior phrenic artery was divided. We believe that this procedure allows the MAL to be released within a sufficient surgical field and without excess or deficiency. Here, we present the details of six patients who underwent lap-MALR for varying indications; three for pancreaticoduodenal artery aneurysms due to CA obstruction (unruptured, <i>n</i> = 1; ruptured, <i>n</i> = 2), two cases prior to hepato-biliary-pancreatic surgery, and one symptomatic case. In all cases, lap-MALR was performed as described above, and the CA stenosis was successfully released. Our case series demonstrates the safety and reliability of our lap-MALR procedure in the treatment of MALS-related disorders, including pancreaticoduodenal artery aneurysms associated with CA compression.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential updates 2022-2023: Surgical and adjuvant therapies for locally advanced colorectal cancer.","authors":"Yoshiki Kajiwara, Hideki Ueno","doi":"10.1002/ags3.12853","DOIUrl":"10.1002/ags3.12853","url":null,"abstract":"<p><p>Pivotal articles that had been published between 2022 and 2023 on surgical and perioperative adjuvant treatments for locally advanced colorectal cancer (CRC) were reviewed. This review focuses on new evidence in the following areas: optimization of surgical procedures for colon cancer, including the optimal length of bowel resection and use of the no-touch isolation technique; minimally invasive surgery for rectal cancer, such as laparoscopic transanal total mesorectal excision and robotic surgery; neoadjuvant treatments for rectal cancer, including total neoadjuvant therapy; neoadjuvant chemotherapy for colon cancer; and postoperative adjuvant chemotherapy for Stage II and III colon cancer. Although the current understanding may not enable perfect decision-making for patients and medical professionals, ongoing advancements are expected to result in more effective personalized treatment plans, ultimately improving the prognosis and quality of life of patients.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase II study of long-course chemoradiotherapy followed by consolidation chemotherapy as total neoadjuvant therapy in locally advanced rectal cancer in Japan: ENSEMBLE-2.","authors":"Yoshinori Kagawa, Koji Ando, Mamoru Uemura, Jun Watanabe, Koji Oba, Yasunori Emi, Nobuhisa Matsuhashi, Naoki Izawa, Osamu Muto, Tatsuya Kinjo, Ichiro Takemasa, Eiji Oki","doi":"10.1002/ags3.12848","DOIUrl":"10.1002/ags3.12848","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the feasibility and safety of total neoadjuvant therapy with long-course chemoradiotherapy followed by consolidation chemotherapy in Japanese patients with locally advanced rectal cancer.</p><p><strong>Methods: </strong>This prospective, multicenter, single-arm, phase II trial was conducted at 10 centers. The eligibility criteria included age ≥20 y, locally advanced rectal cancer within 12 cm of the anal verge, and cT3-4N0M or TanyN+M0 at diagnosis, enabling curative resection. The protocol treatment was capecitabine (1650 mg/m²/day)-based long-course chemoradiotherapy (50.4 Gy/28 fractions) and consolidation chemotherapy (CAPOX, four courses) followed by total mesorectal excision. Nonoperative management was allowed if a clinical complete response was achieved. The primary endpoint was the pathologic complete response rate.</p><p><strong>Results: </strong>Among 28 enrolled patients (19 men, 9 women; median age, 69.5 [41-79] y), the long-course chemoradiotherapy and consolidation chemotherapy completion rates were 100% and 96.4%, respectively. The clinical responses included clinical complete response, (35.7%, 10/28), near-complete response (28.6%, 8/28), and incomplete response (32.1%, 9/28). Total mesorectal excision and nonoperative management were performed in 21 and six patients, respectively. The final analysis included 21 patients. Five patients (23.8% [90% confidence interval 11.8%-41.8%]) achieved pathologic complete response, while 10 of 28 patients (35.7%) achieved a pathological complete response or a sustained clinical complete response. No treatment-related deaths occurred. Grade ≥3 adverse events included diarrhea (7.1%) and leukopenia (7.1%).</p><p><strong>Conclusion: </strong>ENSEMBLE-2 demonstrated comparable pathologic complete response rates and well-tolerated safety of total neoadjuvant therapy with long-course chemoradiotherapy followed by consolidation chemotherapy in Japanese patients with locally advanced rectal cancer.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential updates 2022/2023: Recent advances in perioperative management of esophagectomy to improve operative outcomes.","authors":"Hirotoshi Kikuchi, Eisuke Booka, Yoshihiro Hiramatsu, Hiroya Takeuchi","doi":"10.1002/ags3.12847","DOIUrl":"10.1002/ags3.12847","url":null,"abstract":"<p><p>In the era of minimally invasive surgery, esophagectomy remains a highly invasive procedure with a high rate of postoperative complications. Preoperative risk assessment is essential for planning esophagectomy in patients with esophageal cancer, and it is crucial to implement evidence-based perioperative management to mitigate these risks. Perioperative support from multidisciplinary teams has recently been reported to improve the perioperative nutritional status and long-term survival of patients undergoing esophagectomy. Intraoperative management of anesthesia and fluid therapy also significantly affects short-term outcomes after esophagectomy. In this narrative review, we outline the recent updates in the perioperative management of esophagectomy, focusing on preoperative risk assessment, intraoperative management, and perioperative support by multidisciplinary teams to improve operative outcomes.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative geniohyoid muscle mass in esophageal cancer patients is associated with swallowing function after esophagectomy","authors":"Sanshiro Kawata,&nbsp;Yoshihiro Hiramatsu,&nbsp;Junko Honke,&nbsp;Tomohiro Murakami,&nbsp;Eisuke Booka,&nbsp;Tomohiro Matsumoto,&nbsp;Yoshifumi Morita,&nbsp;Hirotoshi Kikuchi,&nbsp;Katsuya Yamauchi,&nbsp;Hiroya Takeuchi","doi":"10.1002/ags3.12839","DOIUrl":"10.1002/ags3.12839","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Dysphagia often develops after esophagectomy. The geniohyoid muscle is involved in swallowing movements, but its significance in esophagectomy patients remains unclear. We investigated the relationship of preoperative geniohyoid muscle mass with post-esophagectomy swallowing function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method<b>s</b></h3>\u0000 \u0000 <p>We retrospectively analyzed 114 patients who underwent esophagectomy and gastric conduit reconstruction for esophageal malignancy. We evaluated preoperative geniohyoid muscle sagittal cross-sectional areas (cm²) using computed tomography. Median values for each sex were considered as cutoff values. Dysphagia severity was assessed using the Penetration–Aspiration Scale (PAS) during video-fluoroscopic swallowing studies performed 7–10 days postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cross-sectional area was significantly larger in males than in females (3.2 ± 0.7 vs. 2.4 ± 0.5, <i>p</i> &lt; 0.01: median in males: 3.2 cm², and in females: 2.3 cm²). These values were used to define high and low cross-sectional area groups. The cross-sectional area correlated positively with grip strength (correlation coefficient (CC) = 0.530) and skeletal muscle index (CC = 0.541). Transthyretin levels (22.4 ± 6.8 vs. 25.4 ± 5.5, <i>p</i> = 0.03) and cross-sectional area (2.6 ± 0.7 vs. 3.2 ± 0.8, <i>p</i> &lt; 0.01) were significantly lower in patients with (PAS score ≥6; 20%) than in those without aspiration during fluoroscopic swallowing studies. Recurrent laryngeal nerve palsy was significantly more frequent in those with than in those without aspiration during fluoroscopic studies (22% vs. 5%, <i>p</i> = 0.03). In the multivariate analysis, low cross-sectional area and recurrent laryngeal nerve palsy were both independent risk factors for aspiration during swallowing studies (odds ratio = 3.6, <i>p</i> = 0.03 and odds ratio = 6.6, <i>p</i> = 0.02, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative geniohyoid muscle mass, evaluated using neck computed tomography, can predict dysphagia after esophagectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential updates 2022/2023: A review of current topics in robotic hepatectomy","authors":"Tomohiko Adachi,&nbsp;Takanobu Hara,&nbsp;Hajime Matsushima,&nbsp;Akihiko Soyama,&nbsp;Susumu Eguchi","doi":"10.1002/ags3.12817","DOIUrl":"10.1002/ags3.12817","url":null,"abstract":"<p>The liver requires careful handling intra-operatively owing to its vital functions and complexity. Traditional open hepatectomy, while standard, is invasive and requires long recovery periods. Laparoscopic hepatectomy is a less invasive option, with its own challenges. The rise of robotic surgery, such as the da Vinci® system, improves precision and control, addressing the limitations of conventional methods, but brings new concerns, such as costs and training. This review focuses on the latest advancements in robotic hepatectomy from 2022/23 articles, delving into topics like “robotic surgery in liver transplantation,” “robotic hepatectomy for hilar cholangiocarcinoma,” “robotic vascular reconstruction following hepatectomy,” “robotic repeat hepatectomy,” and “prospective trials in robotic hepatectomy.” To retrieve articles, a focused literature search was conducted using PubMed for articles from 2022/23 with a 5-year filter, excluding reviews. Initially, abstracts were screened, and relevant articles on robotic surgery were examined in full for inclusion in this review. Although all the above items are cutting-edge, and many of the references are necessarily at the level of case reports, recent articles are still accompanied by surgical videos, which are useful to readers, especially surgeons who are considering imitating the procedures. In summary, we examined the recent advancements in robotic liver resection. The inclusion of videos that present new techniques aids in knowledge transfer. We anticipate the continued growth of this field of research.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified oral antibiotics and mechanical bowel preparation (OAMBP) versus conventional OAMBP for sigmoid colon and rectal surgery: A multicenter randomized non-inferiority trial.","authors":"Sodai Arai, Marie Hanaoka, Shinichi Yamauchi, Hironobu Baba, Ryoichi Hanazawa, Hiroyuki Sato, Akihiro Hirakawa, Masanori Tokunaga, Yusuke Kinugasa","doi":"10.1002/ags3.12837","DOIUrl":"10.1002/ags3.12837","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate whether the use of a laxative with reduced patient burden in oral antibiotics and mechanical bowel preparation (OAMBP) could prevent surgical site infection (SSI) in left-sided colon and rectal cancers.</p><p><strong>Methods: </strong>This multicenter, non-blinded, randomized, non-inferiority trial included patients who underwent elective colorectal surgery for colorectal cancer in a university and community hospital in Japan from April 1, 2021 to March 31, 2023. We compared conventional OAMBP (polyethylene glycol, metronidazole, and kanamycin) (cOAMBP group) with modified OAMBP (sodium picosulfate hydrate, metronidazole, and kanamycin) (mOAMBP group). The primary outcome was overall incidence of SSI. Secondary outcomes were postoperative complications, degree of patient burden, and intraoperative bowel dilatation.</p><p><strong>Results: </strong>Among 119 patients, 112 were randomly assigned to the two groups, with 56 patients in each group. SSI occurred in three (5.4%) and five patients (8.3%) in the mOAMBP and cOAMBP groups, respectively (90% confidence interval [CI]: -12.8-5.3), with a 15% margin of non-inferiority. Anastomotic leakage occurred in no patient in the mOAMBP group and three patients (5.4%) in the cOAMBP group (<i>p</i> = 0.24). The cOAMBP group reported significantly more pain than the mOAMBP group (50 [90.9%] vs. 7 [12.5%] participants). The mOAMBP group showed significantly lesser bowel dilatation than the cOAMBP group (1 [1.8%] vs. 21 [37.5%] participants).</p><p><strong>Conclusion: </strong>mOAMBP is safe and less burdensome, can reduce intraoperative bowel dilatation, and is non-inferior compared with cOAMBP in preventing SSI. Therefore, mOAMBP may be more suitable for sigmoid colon and rectal cancer.</p><p><strong>Trial registration: </strong>UMIN000043162 (http://www.umin.ac.jp/ctr/). Registered on January 28, 2021.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of venous collateral development after splenic vein occlusion associated with surgical and oncological outcomes after distal pancreatectomy.","authors":"Keishi Sugimachi, Tomonari Shimagaki, Takahiro Tomino, Emi Onishi, Yohei Mano, Tomohiro Iguchi, Masahiko Sugiyama, Yasue Kimura, Masaru Morita, Yasushi Toh","doi":"10.1002/ags3.12830","DOIUrl":"10.1002/ags3.12830","url":null,"abstract":"<p><strong>Aims: </strong>Splenic vein occlusion (SpVO) due to a pancreatic tumor may result in the development of collateral circulation and left-sided portal hypertension. This study aimed to investigate the impact of SpVO on distal pancreatectomy (DP) and provide insights about the management of such cases.</p><p><strong>Methods: </strong>This retrospective analysis included 124 patients who underwent DP from 2014 to 2022. A subgroup analysis was performed on 88 patients who underwent DP for pancreatic ductal adenocarcinoma (PDAC).</p><p><strong>Results: </strong>SpVO was found in 26 (20.8%) patients. The patients with SpVO had significantly larger splenic volumes and lower platelet counts. Compared to the patients with patent splenic veins (SpVs), the patients with SpVO underwent significantly longer operations (<i>p</i> = 0.006), with a higher incidence of postoperative complications (<i>p</i> = 0.002). We classified the collateral routes associated with SpVO into five patterns. The most common pattern was the left gastroepiploic vein type, which was associated with a tumor of the pancreatic body. In patients with PDAC, SpVO was associated with larger tumors, microscopic vascular permeation, and peritoneal recurrence. However, the differences between overall and recurrence-free survival rates in the patients with SpVO vs those with patent SpVs were not significant.</p><p><strong>Conclusions: </strong>SpVO causes left-sided portal hypertension, which can be a risk for perioperative complications in DP. Operative planning based on the classification of collateral flow patterns may help prevent intraoperative congestion and perioperative complications.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, mortality, survival, and treatment statistics of cancers in digestive organs-Japanese cancer statistics 2024.","authors":"Takahiro Higashi, Yukinori Kurokawa","doi":"10.1002/ags3.12835","DOIUrl":"10.1002/ags3.12835","url":null,"abstract":"<p><p>Access to accurate statistical data is paramount in the pursuit of effective cancer control activities, including research, policy development, and clinical care. This paper presents a comprehensive statistical report on the incidence, mortality, survival, and treatment of major digestive organ cancers, including those of the esophagus, stomach, colon, rectum, liver, extrahepatic biliary tract, and pancreas, in Japan. We compiled data from the National Cancer Center's \"Cancer Information Services\" and government \"e-Stat\" websites and offered a succinct overview of basic statistics by using tables and graphical presentations. Our findings underscore the critical role of the National Cancer Registry introduced by the Cancer Registry Act of 2016, which mandates hospitals across Japan to report cancer cases. This system ensures more accurate incidence statistics. Mortality data sourced from the National Vital Statistics System and survival rates derived from hospital-based cancer registries offer insights into the outcomes and efficacy of treatment modalities. These data indicate a downward trend in mortality for stomach and liver cancers and stable or declining rates for other cancers except pancreatic cancer, which has the lowest survival rate. Treatment patterns indicate an increase in endoscopic procedures for esophageal and stomach cancers, with stable treatment approaches for colorectal cancer. This statistical overview aims to improve the understanding and inform research, policy, and clinical decisions in the field of digestive organ cancers.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of actual 5‐y recurrence‐free survival after upfront surgery for resectable pancreatic cancer","authors":"Masao Uemura, T. Sugiura, R. Ashida, K. Ohgi, M. Yamada, S. Otsuka, T. Aramaki, A. Notsu, K. Uesaka","doi":"10.1002/ags3.12834","DOIUrl":"https://doi.org/10.1002/ags3.12834","url":null,"abstract":"The present study investigated the prognostic factors associated with actual 5‐y recurrence‐free survival (RFS) after upfront surgery for resectable pancreatic cancer (R‐PC) in patients who were deemed not to require neoadjuvant treatment.Between 2007 and 2016, 316 patients who underwent pancreatectomy for radiologically R‐PC were retrospectively reviewed to evaluate the predictors of actual 5‐y RFS. Predictors were identified using logistic regression analysis of preoperative evaluable factors. The cutoff values for continuous variables were determined based on a minimum p‐value approach (model 1) or the value that maximized the rate of 5‐y RFS survivors (model 2).Fifty‐one patients (16.1%) achieved a 5‐y RFS. A tumor size ≤23 mm, the absence of serosal invasion on computed tomography (CT), and Neutrophil‐to‐Lymphocyte Ratio <1.0, were significantly associated with the 5‐y RFS in model 1. A Prognostic Nutritional Index ≥58 and the absence of serosal invasion and extrapancreatic nerve plexus invasion on CT were significantly associated with 5‐y RFS in model 2. Only six (11.8%, model 1) and four (7.8%, model 2) patients had all three prognostic factors, and their 5‐y RFS rates were 83.3% and 100%, respectively.A modest number of patients who underwent upfront surgery achieved 5‐y RFS, but only ~10% of them could be identified preoperatively. Based on these results, almost all R‐PC patients are forced to undergo neoadjuvant treatment in daily practice.","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}