根治性顺行模块化胰脾切除术治疗左侧胰腺导管腺癌可能降低局部复发率。
Radical Antegrade Modular Pancreatosplenectomy for Left-Sided Pancreatic Ductal Adenocarcinoma May Reduce the Local Recurrence Rate.
作者信息
Kiritani Sho, Kaneko Junichi, Arita Junichi, Ishizawa Takeaki, Akamatsu Nobuhisa, Hasegawa Kiyoshi
机构信息
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
出版信息
Dig Surg. 2022;39(4):191-200. doi: 10.1159/000524927. Epub 2022 May 9.
INTRODUCTION
Although several clinical applications have reported the usefulness of the radical antegrade modular pancreatosplenectomy (RAMPS) procedure for left-sided pancreatic ductal adenocarcinoma, few studies have reported the advantages of RAMPS with respect to the local recurrence (LR) rate.
METHODS
As of 2018, 68 and 62 patients underwent RAMPS and standard retrograde pancreatosplenectomy (SRPS). The first recurrence and all subsequent recurrence sites observed on images during a follow-up period and/or chemotherapy. The clinical variables are collected retrospectively.
RESULTS
LR only was found in 5 patients in the RAMPS group (5/68, 7.3%) and in 15 patients in the SRPS group (15/62, 24.2%; p = 0.008) as the first recurrence site. Any chemotherapies were not a risk factor for the incidence of LR. The 5-year cumulative LR rate was significantly lower in patients in the RAMPS group compared with those in the SRPS group (23.6% vs. 49.6%; p = 0.019). The 5-year overall survival was 42.2% in the RAMPS group and 33.0% in the SRPS group (p = 0.251).
CONCLUSION
The RAMPS procedure for left-sided pancreatic ductal adenocarcinoma may reduce the LR, cumulative LR rates.
引言
尽管多项临床应用报告了根治性顺行模块化胰脾切除术（RAMPS）治疗胰体尾导管腺癌的有效性，但很少有研究报道RAMPS在局部复发（LR）率方面的优势。
方法
截至2018年，68例和62例患者分别接受了RAMPS和标准逆行胰脾切除术（SRPS）。在随访期间和/或化疗期间通过影像学观察首次复发及所有后续复发部位。回顾性收集临床变量。
结果
作为首次复发部位，RAMPS组有5例患者仅出现局部复发（5/68，7.3%），SRPS组有15例患者出现局部复发（15/62，24.2%；p = 0.008）。任何化疗均不是局部复发发生率的危险因素。与SRPS组患者相比，RAMPS组患者的5年累积局部复发率显著更低（23.6%对49.6%；p = 0.019）。RAMPS组的5年总生存率为42.2%，SRPS组为33.0%（p = 0.251）。
结论
用于治疗胰体尾导管腺癌的RAMPS手术可能会降低局部复发及累积局部复发率。
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