Department of Surgery, Evanston Hospital, North Shore University Health System, Evanston, Illinois, USA.
Division of Hepatobiliary and Pancreas, Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
J Surg Oncol. 2023 Jul;128(1):23-32. doi: 10.1002/jso.27240. Epub 2023 Mar 20.
This study sought to investigate the impact of minimally invasive surgery (MIS) on recurrence and overall survival between patients with pancreatic head versus body/tail cancers.
The risk factors associated with recurrence and long-term outcomes were analyzed according to tumor location and operative modality.
A total of 288 and 87 patients underwent surgical resection for pancreatic head cancer and body/tail cancer, respectively. The perioperative outcomes and histopathologic results were comparable in open and MIS approach in both head and body/tail groups. There was no difference in local or systemic recurrence patterns and disease-free and overall survival rates according to primary tumor location and surgical modality. During subgroup analysis by stage; however, patients with stage III pancreatic head cancer in the MIS group had a decreased disease-free survival compared with those in the open surgery group (p = 0.020). On multivariate analysis, MIS was not a risk factor of total or local recurrences.
Recurrence patterns and overall survival rates of patients did not differ according to tumor location and surgical approach. However, patients with stage III pancreatic head cancer in the MIS group showed inferior disease-free survival relative to patients who underwent open surgery.
本研究旨在探讨微创外科（MIS）对胰头癌与胰体尾癌患者复发和总生存的影响。
根据肿瘤位置和手术方式分析与复发和长期预后相关的危险因素。
共有 288 例和 87 例患者分别因胰头癌和胰体尾癌接受了手术切除。在头、体尾两组中，开放和 MIS 两种方式的围手术期结果和组织病理学结果相当。根据原发肿瘤位置和手术方式，局部或全身复发模式以及无病生存率和总生存率无差异。然而，在按分期进行的亚组分析中，MIS 组 III 期胰头癌患者的无病生存率低于开放手术组（p=0.020）。多因素分析显示，MIS 不是总复发或局部复发的危险因素。
根据肿瘤位置和手术方式，患者的复发模式和总生存率没有差异。然而，MIS 组 III 期胰头癌患者的无病生存率相对较差，低于接受开放手术的患者。
