Distal Pancreatectomy with en Bloc Celiac Axis Resection (Modified Appleby Procedure) for Locally Advanced Pancreatic Body Cancer: A Single-Center Review ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-08-05

AUTHORS

Toru Nakamura, Satoshi Hirano, Takehiro Noji, Toshimichi Asano, Keisuke Okamura, Takahiro Tsuchikawa, Soichi Murakami, Yo Kurashima, Yuma Ebihara, Yoshitsugu Nakanishi, Kimitaka Tanaka, Toshiaki Shichinohe

ABSTRACT

BackgroundRecently, distal pancreatectomy with en bloc celiac axis resection (DP-CAR) or modified Appleby procedure for locally advanced pancreatic body cancer is increasingly reported. However, actual long-term survival data are still unknown.MethodsThis study retrospectively reviewed 80 consecutive patients with pancreatic body cancer who underwent DP-CAR at a single institution.ResultsThe study included 40 men and 40 women with a median age of 65 years (range, 44–85 years). A pancreatic fistula was the most common complication, occurring in 47 patients (57.5 %). Other complications with a high incidence were ischemic gastropathy (23 patients, 28.8 %) and delayed gastric emptying (20 patients, 25 %). According to the Clavien-Dindo classification, the major complications, defined as complications of grade 3 or higher, were observed in 33 patients (41.3 %), and the in-hospital mortality involved four patients (5 %). For all 80 patients, the 1-, 2-, and 5-year overall survivals (OSs) were respectively 81.1, 56.9, and 32.7 %, and the median survival time was 30.9 months. The actual 5-year survival for the 61 patients whose surgery was performed five or more years earlier was 27.9 % (17 of 61). The 1-, 2-, and 5-year OSs for the patients who underwent preoperative therapy (100, 90, and 78.8 %) were significantly better than for those who underwent upfront surgery (77.9, 51.5, and 26.7 %; P < 0.0001).ConclusionsThe findings show DP-CAR to be a valid procedure for treating locally advanced pancreatic body cancer, which might contribute more to patients’ survival when performed as part of multidisciplinary treatment. More... »

PAGES

969-975

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-016-5493-8

DOI

http://dx.doi.org/10.1245/s10434-016-5493-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052184532

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27495282


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35 schema:description BackgroundRecently, distal pancreatectomy with en bloc celiac axis resection (DP-CAR) or modified Appleby procedure for locally advanced pancreatic body cancer is increasingly reported. However, actual long-term survival data are still unknown.MethodsThis study retrospectively reviewed 80 consecutive patients with pancreatic body cancer who underwent DP-CAR at a single institution.ResultsThe study included 40 men and 40 women with a median age of 65 years (range, 44–85 years). A pancreatic fistula was the most common complication, occurring in 47 patients (57.5 %). Other complications with a high incidence were ischemic gastropathy (23 patients, 28.8 %) and delayed gastric emptying (20 patients, 25 %). According to the Clavien-Dindo classification, the major complications, defined as complications of grade 3 or higher, were observed in 33 patients (41.3 %), and the in-hospital mortality involved four patients (5 %). For all 80 patients, the 1-, 2-, and 5-year overall survivals (OSs) were respectively 81.1, 56.9, and 32.7 %, and the median survival time was 30.9 months. The actual 5-year survival for the 61 patients whose surgery was performed five or more years earlier was 27.9 % (17 of 61). The 1-, 2-, and 5-year OSs for the patients who underwent preoperative therapy (100, 90, and 78.8 %) were significantly better than for those who underwent upfront surgery (77.9, 51.5, and 26.7 %; P < 0.0001).ConclusionsThe findings show DP-CAR to be a valid procedure for treating locally advanced pancreatic body cancer, which might contribute more to patients’ survival when performed as part of multidisciplinary treatment.
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42 Clavien-Dindo classification
43 ConclusionsThe findings
44 DP-CAR
45 MethodsThis study
46 ResultsThe study
47 advanced pancreatic body cancer
48 age
49 body cancer
50 cancer
51 celiac axis resection
52 classification
53 common complication
54 complications
55 consecutive patients
56 data
57 distal pancreatectomy
58 en bloc celiac axis resection
59 findings
60 fistula
61 gastropathy
62 grade 3
63 high incidence
64 hospital mortality
65 incidence
66 institutions
67 ischemic gastropathy
68 long-term survival data
69 major complications
70 median age
71 median survival time
72 men
73 months
74 more years
75 mortality
76 multidisciplinary treatment
77 overall survival
78 pancreatectomy
79 pancreatic body cancer
80 pancreatic fistula
81 part
82 patients
83 preoperative therapy
84 procedure
85 resection
86 review
87 single institution
88 single-center review
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90 surgery
91 survival
92 survival data
93 survival time
94 therapy
95 time
96 treatment
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98 valid procedure
99 women
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