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Am J Surg. 2017 Apr;213(4):601-605. doi: 10.1016/j.amjsurg.2017.01.005. Epub 2017 Jan 7.

Impact of minimally invasive vs. open distal pancreatectomy on use of adjuvant chemoradiation for pancreatic adenocarcinoma.

Author information

1
Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: kla24@duke.edu.
2
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: mohamed.adam@dm.duke.edu.
3
Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA. Electronic address: samantha.thomas@dm.duke.edu.
4
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA. Electronic address: sanziana.roman@dm.duke.edu.
5
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA; Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA; Duke Clinical Research Institute, Durham, NC 27710, USA. Electronic address: julie.sosa@dm.duke.edu.

Abstract

BACKGROUND:

Published data examining the impact of minimally invasive distal pancreatectomy (MIDP) on survival are generally limited to experiences from high-volume institutions. Our aim was to compare utilization of adjuvant chemoradiation and time from surgery until its initiation following MIDP vs. open surgery (ODP) at a national level.

METHODS:

Adult patients undergoing distal pancreatectomy for Stage I and II pancreatic adenocarcinoma were identified from the National Cancer Data Base, 2010-2012.

RESULTS:

A total of 1807 patients underwent distal pancreatectomy for adenocarcinoma at 506 institutions (27.9% MIDP). After adjustment, those who underwent MIDP were more likely to have complete tumor resections and a shorter hospital length of stay. Patients undergoing MIDP vs. ODP were more likely to receive adjuvant chemotherapy; time to initiation of adjuvant chemotherapy or radiation was not different between groups. After adjustment, overall survival for MIDP vs. ODP remained similar (HR 0.85, CI 0.67-1.10, p = 0.21).

CONCLUSION:

MIDP is associated with increased use of adjuvant chemotherapy; further study is needed to understand the etiology and impact of this association.

KEYWORDS:

Adjuvant chemotherapy; Adjuvant radiation; Distal pancreatectomy; Minimally invasive; Outcomes; Pancreatic adenocarcinoma

PMID:
28093119
DOI:
10.1016/j.amjsurg.2017.01.005
[Indexed for MEDLINE]

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