0 80

Cited 0 times in

The Impact of Neoadjuvant Treatment on Survival in Patients Undergoing Pancreatoduodenectomy With Concomitant Portomesenteric Venous Resection: An International Multicenter Analysis

Authors
 Nikolaos Machairas  ;  Dimitri A Raptis  ;  Patricia Sánchez Velázquez  ;  Alain Sauvanet  ;  Alexandra Rueda de Leon  ;  Atsushi Oba  ;  Bas Groot Koerkamp  ;  Brendan Lovasik  ;  Carlos Chan  ;  Charles J Yeo  ;  Claudio Bassi  ;  Cristina R Ferrone  ;  David Kooby  ;  David Moskal  ;  Domenico Tamburrino  ;  Dong-Sup Yoon  ;  Eduardo Barroso  ;  Eduardo de Santibañes  ;  Emanuele F Kauffmann  ;  Emanuel Vigia  ;  Fabien Robin  ;  Fabio Casciani  ;  Fernando Burdío  ;  Giulio Belfiori  ;  Giuseppe Malleo  ;  Harish Lavu  ;  Hermien Hartog  ;  Ho-Kyoung Hwang  ;  Ho-Seong Han  ;  Hugo P Marques  ;  Ignasi Poves  ;  Ismael Domínguez-Rosado  ;  Joon-Seong Park  ;  Keith D Lillemoe  ;  Keith Roberts  ;  Laurent Sulpice  ;  Marc G Besselink  ;  Mahmoud Abuawwad  ;  Marco Del Chiaro  ;  Martin de Santibañes  ;  Massimo Falconi  ;  Mizelle D'Silva  ;  Michael Silva  ;  Mohammed Abu Hilal  ;  Motaz Qadan  ;  Naomi M Sell  ;  Nassiba Beghdadi  ;  Niccolò Napoli  ;  Olivier R C Busch  ;  Oscar Mazza  ;  Paolo Muiesan  ;  Philip C Müller  ;  Reena Ravikumar  ;  Richard Schulick  ;  Sarah Powell-Brett  ;  Syed Hussain Abbas  ;  Tara M Mackay  ;  Thomas F Stoop  ;  Tom K Gallagher  ;  Ugo Boggi  ;  Casper van Eijck  ;  Pierre-Alain Clavien  ;  Kevin C P Conlon  ;  Giuseppe Kito Fusai 
Citation
 ANNALS OF SURGERY, Vol.274(5) : 721-728, 2021-11 
Journal Title
ANNALS OF SURGERY
ISSN
 0003-4932 
Issue Date
2021-11
MeSH
Aged ; Europe / epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenteric Veins / surgery* ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Pancreas / blood supply* ; Pancreas / surgery ; Pancreatic Neoplasms / blood supply ; Pancreatic Neoplasms / mortality ; Pancreatic Neoplasms / surgery* ; Pancreaticoduodenectomy / methods* ; Portal Vein / surgery* ; Retrospective Studies ; Survival Rate / trends ; Time Factors ; Vascular Surgical Procedures / methods*
Abstract
Objective: The aim of this study was to evaluate whether neoadjuvant therapy (NAT) critically influenced microscopically complete resection (R0) rates and long-term outcomes for patients with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy (PD) with portomesenteric vein resection (PVR) from a diverse, world-wide group of high-volume centers.

Summary of background data: Limited size studies suggest that NAT improves R0 rates and overall survival compared to upfront surgery in R/BR-PDAC patients.

Methods: This multicenter study analyzed consecutive patients with R/BR-PDAC who underwent PD with PVR in 23 high-volume centers from 2009 to 2018.

Results: Data from 1192 patients with PD and PVR were collected and analyzed. The median age was 68 [interquartile range (IQR) 60-73] years and 52% were males. Some 186 (15.6%) and 131 (10.9%) patients received neoadjuvant chemotherapy (NAC) alone and neoadjuvant chemoradiotherapy, respectively. The R0/R1/R2 rates were 57%, 39.3%, and 3.2% in patients who received NAT compared to 46.6%, 49.9%, and 3.5% in patients who did not, respectively (P =0.004). The 1-, 3-, and 5-year OS in patients receiving NAT was 79%, 41%, and 29%, while for those that did not it was 73%, 29%, and 18%, respectively (P <0.001). Multivariable analysis showed no administration of NAT, high tumor grade, lymphovascular invasion, R1/R2 resection, no adjuvant chemotherapy, occurrence of Clavien-Dindo grade 3 or higher postoperative complications within 90 days, preoperative diabetes mellitus, male sex and portal vein involvement were negative independent predictive factors for OS.

Conclusion: Patients with PDAC of the pancreatic head expected to undergo venous reconstruction should routinely be considered for NAT.
Full Text
https://journals.lww.com/annalsofsurgery/Fulltext/2021/11000/The_Impact_of_Neoadjuvant_Treatment_on_Survival_in.7.aspx
DOI
10.1097/SLA.0000000000005132
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187581
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links