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Minimally Invasive Versus Open Pancreatectomy for Right-Sided and Left-Sided G1/G2 Nonfunctioning Pancreatic Neuroendocrine Tumors: A Multicenter Matched Analysis with an Inverse Probability of Treatment-Weighting Method

 Ho Kyoung Hwang  ;  Ki Byung Song  ;  Minsu Park  ;  Wooil Kwon  ;  Jin-Young Jang  ;  Jin Seok Heo  ;  Dong Wook Choi  ;  Chang Moo Kang  ;  Joon Seong Park  ;  Tae Ho Hong  ;  Chol Kyoon Cho  ;  Keun Soo Ahn  ;  Huisong Lee  ;  Seung Eun Lee  ;  Chi-Young Jeong  ;  Young Hoon Roh  ;  Hee Joon Kim  ;  Dae Wook Hwang  ;  Song Cheol Kim  ;  Ho-Seong Han  ;  Yoo-Seok Yoon 
 ANNALS OF SURGICAL ONCOLOGY, Vol.28(12) : 7742-7758, 2021-11 
Journal Title
Issue Date
Humans ; Minimally Invasive Surgical Procedures ; Neuroendocrine Tumors* / surgery ; Pancreatectomy ; Pancreatic Neoplasms* / surgery ; Pancreaticoduodenectomy ; Propensity Score ; Retrospective Studies ; Treatment Outcome
Background: Limited evidence exists for the safety and oncologic efficacy of minimally invasive surgery (MIS) for nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) according to tumor location. This study aimed to compare the surgical outcomes of MIS and open surgery (OS) for right- or left-sided NF-PNETs.

Methods: The study collected data on patients who underwent surgical resection (pancreatoduodenectomy, distal/total/central pancreatectomy, duodenum-preserving pancreas head resection, or enucleation) of a localized NF-PNET between January 2000 and July 2017 at 14 institutions. The inverse probability of treatment-weighting method with propensity scores was used for analysis.

Results: The study enrolled 859 patients: 478 OS and 381 MIS patients. A matched analysis by tumor location showed no differences in resection margin, intraoperative blood loss, or complications between MIS and OS. However, MIS was associated with a longer operation time for right-sided tumors (393.3 vs 316.7 min; P < 0.001) and a shorter postoperative hospital stay for left-sided tumors (8.9 vs 12.9 days; P < 0.01). The MIS group was associated with significantly higher survival rates than the OS group for right- and left-sided tumors, but survival did not differ for the patients divided by tumor grade and location. Multivariable analysis showed that MIS did not affect survival for any tumor location.

Conclusion: The short-term outcomes offered by MIS were comparable with those of OS except for a longer operation time for right-sided NF-PNETs. The oncologic outcomes were not compromised by MIS regardless of tumor location or grade. These findings suggest that MIS can be performed safely for selected patients with localized NF-PNETs.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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