Modern principles of treatment of patients with locally advanced pancreatic cancer
DOI:
https://doi.org/10.32782/2415-8127.2023.68.9Keywords:
extended pancreatic resections, pancreatic adenocarcinoma, locally advanced pancreatic cancer, venous resections, vascular reconstruction, arterial resectionsAbstract
Aim. To evaluate the outcome of extended pancreatectomy in treatment of patients with locally advanced pancreatic cancer. Matherials and Methods. In the period 2010–2020 we performed 645 resections in patients with pancreatic adenocarcinoma: distal pancreatectomy – in 104 (16,2%), pancreaticoduodenectomy – in 522 (80,9%) and total pancreatectomy – in 19 (2,9%) patients. Among patients sex there were female – 287 (44,5%), male – 358 (55,5%). Average age was 57,7±10,5 (from 22 to 81). Extended pancreatectomy were performed in 149 (23,1%) patients: extended pancreaticoduodenectomy – in 82 (55,0%), extended distal resections – in 56 (37,6%), extended pancreatectomy – in 11 (7,4%). Extended resections with resections of vein were performed in 104 (69,8%) patients, with arterial resections – in 11 (7,4%) patients. Results. Postoperative complications occurred in 183 patients (36,9%) in the standard resection group and in 63 (42,3%) in the group with extended resections (χ2=1,4, p=0,23), without significant difference. Mortality was 2,8%, 18 patients died: 5 (3,5%) – after extended resections and 13 (2,6%) – after standard pancreatectomy, without significant difference in the mortality rate (χ2 = 0,39, p=0,53). Median survival and 5-year overall survival rate were reduced in patients having EP compared with those undergoing a standard resection (21 months, 26% and 28 months, 29%, χ2 = 0,16, p=0,69, p>0,05). Conclusion: The present results suggest that morbidity, mortality, long term results after EP are comparable with standard pancreatectomy. Extended resections are possible and can increase the number of radically operated patients.
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