Surgical treatment of patients with locally advanced pancreatic cancer

Authors

  • V. M. Kopchak O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • M. V. Kostyliev O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • L. O. Pererva O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • O. V. Duvalko O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • V. V. Khanenko O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • H. H. Shevkolenko O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • S. V. Andronik O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv
  • V. I. Trachuk O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv

DOI:

https://doi.org/10.11603/2414-4533.2020.1.10737

Keywords:

extended pancreatectomy, pancreatic adenocarcinoma, locally advanced pancreatic cancer, venous resections, vascular reconstruction, arterial resections

Abstract

The aim of the work: to evaluate the outcome of extended pancreatectomy in treatment of patients with locally advanced pancreatic cancer.

Materials and Methods. In the period 2010–2018 we performed 618 resections in patients with pancreatic adenocarcinoma: distal pancreatectomy – in 139 (22.5 %), pancreaticoduodenectomy – in 462 (74.8 %) and total pancreatectomy – in 17 (2.7%) patients. Among patients there were 262 (42.4 %) women and 356 (57.6 %) men. Average age was (55.9±9.4) (from 27 to 87).

Extended pancreatectomy was performed in 142 (23.0 %) patients: extended pancreaticoduodenectomy – in 79 (55.6 %), extended distal resections – in 52 (36.6 %), extended pancreatectomy – in 11 (7.8 %). Extended resections with resections of vein were performed in 91 (14.7 %) patients, with arterial resections – in 14 (2.3 %) patients.

Results and Discussion. Postoperative complications occurred in 182 patients (38.2 %) in the standard resection group and in 63 (44.3 %) in the group with extended resections (χ2 = 1.26 p=0.26), without significant difference. Mortality was 2.4 %, 15 patients died: 6 (4.2 %) – after extended resections and 9 (1.9 %) – after standard pancreatectomy (χ2 = 1.3, p=0.25). Median survival and 5-year overall survival rate were reduced in patients having extended pancreatectomy compared with those undergoing a standard resection (15 months, 18 % and 25 months, 33 %; χ2= 2.83, p= 0.09, p>0,05, χ2 = 0.16, p=0,69). 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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Published

2020-01-16

How to Cite

Kopchak, V. M., Kostyliev, M. V., Pererva, L. O., Duvalko, O. V., Khanenko, V. V., Shevkolenko, H. H., … Trachuk, V. I. (2020). Surgical treatment of patients with locally advanced pancreatic cancer. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 51–57. https://doi.org/10.11603/2414-4533.2020.1.10737

Issue

No. 1 (2020)

Section

EXPERIENCE OF WORK

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