Distal Pancreatectomy with En Bloc Celiac Axis Resection for Locally Advanced Pancreatic Adenocarcinoma Following Neoadjuvant Therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-03-08

AUTHORS

Joel M. Baumgartner, Alyssa Krasinskas, Mustapha Daouadi, Amer Zureikat, Wallis Marsh, Kenneth Lee, David Bartlett, A. James Moser, Herbert J. Zeh

ABSTRACT

BackgroundCeliac trunk encasement by adenocarcinoma of the pancreatic body is generally regarded as a contraindication for surgical resection. Recent studies have suggested that a subset of stage III patients will succumb to their disease in the absence of distant metastases. We hypothesized that patients with stage III tumors invading the celiac trunk, who are free of distant disease following neoadjuvant therapy, may derive prolonged survival benefit from aggressive surgical resection.MethodsWe performed a retrospective review of distal pancreatectomies with en bloc celiac axis resection for pancreatic adenocarcinoma.ResultsEleven patients underwent a distal pancreatectomy with en bloc celiac axis resection after completing neoadjuvant chemoradiation therapy. Median operative time was 8 h, 14 min, and median estimated blood loss was 700 ml. Median length of stay was 9 days. Five patients (45%) had postoperative complications; three were Clavien grade I. Four patients (35%) had pancreatic leaks; two were ISGPF grade B, and two were grade A. There were two 90-day perioperative deaths. Ten patients had R0 resections (91%). After a median follow-up of 41 weeks, six patients recurred. Four of the five patients with SMAD4 loss recurred, and two of the five patients with intact SMAD4 recurred. Median disease-free and overall survival were 21 weeks and 26 months, respectively.ConclusionsResection of pancreatic body adenocarcinoma with celiac axis resection is technically feasible with acceptable perioperative morbidity and mortality. More... »

PAGES

1152-1159

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-012-1839-0

DOI

http://dx.doi.org/10.1007/s11605-012-1839-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1011292551

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22399269


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85 pancreatectomy
86 pancreatic adenocarcinoma
87 pancreatic body
88 pancreatic body adenocarcinoma
89 pancreatic leak
90 patients
91 perioperative deaths
92 perioperative morbidity
93 postoperative complications
94 resection
95 retrospective review
96 review
97 stage III patients
98 stage III tumors
99 stay
100 study
101 subset
102 surgical resection
103 survival
104 survival benefit
105 therapy
106 time
107 trunk
108 tumors
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