重新评估胰腺癌切除术中切除静脉和动脉的风险和肿瘤效果。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-07-14 DOI:10.1002/jhbp.12048
Mirang Lee, Yoon Soo Chae, Seulah Park, Won-Gun Yun, Hye-Sol Jung, Youngmin Han, Wooil Kwon, Joon Seong Park, Jin-Young Jang
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引用次数: 0

摘要

背景:化疗的进展导致胰腺切除术中的主要血管切除术越来越多,但由于高发病率,这一直是禁忌症。本研究旨在验证新辅助治疗时代胰腺切除术中血管切除的安全性和肿瘤学结果:方法:研究人员回顾了 2001 年至 2021 年期间在首尔大学医院接受胰腺癌手术的患者数据。根据血管切除情况分析临床病理结果。进行倾向分数匹配(PSM)分析以评估生存结果:结果:在1596名患者中,接受血管切除术的比例从9.2%上升到23.4%,间隔时间为5年。血管切除组和非血管切除组在主要并发症(15.6% 对 13.0%;P = .266)和 30 天死亡率(0.3% 对 0.6%;P = .837)方面没有差异。PSM 后,血管切除组与非血管切除组的生存结果相当(5 年生存率为 20.4% vs. 23.7%;p = .194)。动脉切除术与非血管切除术的生存率相当(5年生存率为38.1% vs. 23.7%; p = .138):结论:在新辅助治疗时代,对于精心挑选的根治性手术患者,适当的血管切除--即使是动脉切除--也是安全有效的。需要进一步研究确定胰腺癌患者血管切除的最佳适应症和方法。
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Re-evaluation of risk and oncological outcomes of resection of veins and arteries in the resection of pancreatic cancer

Background

Advances in chemotherapy have led to increasing major vascular resection during pancreatectomy which has been contraindicated due to high morbidity. This study aimed to verify the safety and oncological outcomes of vascular resection during pancreatectomy in the era of neoadjuvant therapy.

Methods

Data from patients who underwent surgery for pancreatic cancer at Seoul National University Hospital between 2001 and 2021 were reviewed. Clinicopathological outcomes were analyzed according vessel resection. A propensity-score-matched (PSM) analysis was performed to evaluate survival outcomes.

Results

Of 1596 patients, the proportion of those who underwent vascular resection increased from 9.2% to 23.4% over time divided into 5-year intervals. There were no differences in major complications (15.6% vs. 13.0%; p = .266) and 30-day mortality rate (0.3% vs. 0.6%; p = .837) between the vascular and nonvascular resection groups. After PSM, the vascular resection group demonstrated comparable survival outcome with the nonvascular resection group (5 year-survival-rate 20.4 vs. 23.7%; p = .194). Arterial resection yielded comparable survival outcome with nonvascular resection (5 year-survival-rate 38.1% vs. 23.7%; p = .138).

Conclusions

Appropriate vascular resection―even arterial―is safe and effective in patients carefully selected for radical surgery in the era of neoadjuvant therapy. Further studies are needed to determine the optimal indication and method for vascular resection in patients with pancreatic cancer.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
期刊最新文献
Minimally invasive approach of hepatectomy and thrombectomy for hepatocellular carcinoma with right atrial tumor thrombus without sternotomy using percutaneous cardiopulmonary bypass. Prognostic significance of creatine kinase in resected pancreatic cancer. Short- and long-term outcomes of liver resection with hepatic vein reconstruction for liver tumors: A nationwide multicenter survey. Issue Information Frailty as a predictor of adverse outcomes in patients with hepatectomy - the importance of design studies to improve frailty: A systematic review and meta-analysis of 128 868 patients.
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