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Pancreatectomy with arterial resection is superior to palliation in patients with borderline resectable or locally advanced pancreatic cancer

2018; Elsevier BV; Volume: 21; Issue: 2 Linguagem: Inglês

10.1016/j.hpb.2018.07.017

1477-2574

Marco Del Chiaro, Elena Rangelova, Asif Halimi, Zeeshan Ateeb, Chiara Maria Scandavini, Roberto Valente, Ralf Segersvärd, Urban Arnelo, Caroline S. Verbeke,

Renal cell carcinoma treatment

Few studies have investigated the outcome of pancreatectomy associated with artery resection (PAR).Retrospective analysis of a cohort of operated borderline or locally advanced pancreatic cancer patients with surgically confirmed arterial involvement. Short and long-term outcome were analyzed and compared in patients who underwent PAR (Group 1) and palliative surgery (Group 2).Of 73 patients who underwent surgical exploration with intent of resection, 34 underwent PAR (±venous resection) (Group 1) and 39 underwent palliation (Group 2). 23 patients (67.7%) in Group 1 underwent combined artery-vein resection (AVR). Operation time was longer and blood loss higher in group 1 compared to group 2. There were no differences in post-operative mortality (2.9% vs 2.6%, p = 0.9) and post-operative surgical complications (38.2% vs 25.6%, p = 0.2). The 1, 3 and 5 years survival in Group 1 was superior to Group 2 (63.7%, 23.4% and Q3 23.4% vs 41.7%, 3.2% and 0, p = 0.003).PAR seems to be safe and feasible in well selected patients and associated with an advantage of survival compared to palliation, in patients affected by locally advanced pancreatic cancer.