Year 2019 / Volume 111 / Number 8
Original
Survival, morbidity and mortality of pancreatic adenocarcinoma after pancreaticoduodenectomy with a total mesopancreas excision

609-614

DOI: 10.17235/reed.2019.6139/2018

Pablo Sánchez Acedo, Javier Herrera Cabezón, Cruz Zazpe Ripa, Antonio Tarifa Castilla,

Abstract
Introduction: pancreatic adenocarcinoma is the most common malignancy in the periampullary region, with a five-year survival rate around 20%. Objective: the goal of our study was to determine the survival and safety data of a number of patients that underwent a cephalic duodenopancreatectomy (CDP) with total mesopancreas excision (TMPE). Material and methods: a prospective observational study was performed of 114 patients with pancreatic adenocarcinoma who underwent duodenopancreatectomy and TMPE over the period 2008-2017. Demographic variables, tumor stage, number of lymph nodes excised, lymph node ratio, R classification, the prognostic factor disease-free interval and survival were all assessed in a multivariate analysis. Results: complications were reported for 54 (47.3%) patients, of which 22 (19.3%) were categorized as serious. The mortality rate was 4.3% and the mean follow-up was 26.2 months. During this period, 73 (64%) patients relapsed after a mean interval of 40.9 months. The relapse pattern was mainly hepatic (26.3%), followed by local relapse (20%). Mean survival was 40.38 and actuarial survival was 26.6% at five years. Relapse-related factors included stage T3 or higher (RR 8.1 [1.1-61]) and an R1 resection (RR 13.4 [2.7-66.5]) and survival-related factors included an R1 resection (RR 10.7 [2.5-46.2]). Conclusion: TMPE ensures an adequate lymphadenectomy and lymph node ratio according to reported standards. The survival of patients that have undergone surgery for pancreatic adenocarcinoma in our institution is 68.4% at one year and 26.6% at five years. An R1 resection is the primary factor for both relapse and survival.
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21/10/2019 6:36:57
Soy cirujano oncológo y me parece interesante ver las tasas de sobrevida en pacientes con cáncer de pancreas cuando se emplea la ETMP

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Sánchez Acedo P, Herrera Cabezón J, Zazpe Ripa C, Tarifa Castilla A. Survival, morbidity and mortality of pancreatic adenocarcinoma after pancreaticoduodenectomy with a total mesopancreas excision. 6139/2018


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Publication history

Received: 22/12/2018

Accepted: 09/02/2019

Online First: 18/07/2019

Published: 31/07/2019

Article revision time: 42 days

Article Online First time: 208 days

Article editing time: 221 days


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