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

2016-12

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

BACKGROUND: Recently, 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. METHODS: This study retrospectively reviewed 80 consecutive patients with pancreatic body cancer who underwent DP-CAR at a single institution. RESULTS: The 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). CONCLUSIONS: The 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

References to SciGraph publications

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  • 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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