Pu Ning, Mu Sucheng, Fang Yuan, Yin Hanlin, Liu Gao, Zhao Guochao, Zhang Lei, Wu Wenchuan, Lou Wenhui
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Transl Cancer Res. 2020 Mar;9(3):1476-1486. doi: 10.21037/tcr.2020.01.38.
It is unclear if the modified extended pancreaticoduodenectomy (PD) has better outcome superior the conventional PD for patients with pancreatic head carcinoma (PHC). The objective of this study is to compare the survival outcomes of the classic PD procedure and the modified extended PD procedure for PHC.
A total of 7,084 resected PHC patients with PD and extended PD procedure from the SEER database from 2004 to 2014 were stratified. With the utilization of propensity score matching (PSM), patient baseline characteristics were balanced to decrease the bias. Overall survival (OS) and cancer-specific survival (CSS) were analyzed in both groups.
Of the 7,084 patients, 6,541 (92.3%) and 543 (7.7%) patients received PD and extended PD surgical procedures, respectively. After 2:1 ratio of PSM, 543 patients with extended PD procedure and 1,084 patients with PD procedure were completely matched. The median CSS and OS for PD and extended PD group were 20.0 and 19.0 months, and 19.0 and 18.0 months, respectively. The 5-year CSS and OS rates for PD and extended PD group were 17.5% and 16.1%, and 13.9% and 13.1%, respectively.
There is no distinct difference in survival outcomes between PD and extended PD procedure in patients with PHC.
对于胰头癌（PHC）患者，改良扩大胰十二指肠切除术（PD）的疗效是否优于传统PD尚不清楚。本研究的目的是比较经典PD手术和改良扩大PD手术治疗PHC的生存结局。
对2004年至2014年SEER数据库中7084例行PD和扩大PD手术的PHC切除患者进行分层。利用倾向评分匹配（PSM）平衡患者基线特征以减少偏差。对两组患者的总生存期（OS）和癌症特异性生存期（CSS）进行分析。
7084例患者中，分别有6541例（92.3%）和543例（7.7%）接受了PD和扩大PD手术。按2:1的PSM比例匹配后，543例接受扩大PD手术的患者与1084例接受PD手术的患者完全匹配。PD组和扩大PD组的CSS和OS中位数分别为20.0个月和19.0个月，以及19.0个月和18.0个月。PD组和扩大PD组的5年CSS率和OS率分别为17.5%和16.1%，以及13.9%和13.1%。
PHC患者中，PD手术和扩大PD手术的生存结局无明显差异。
