Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study. (July 2017)

• Record Type: Journal Article
• Authors: Jang, Jin‐Young; Kang, Jae Seung; Han, Youngmin; Heo, Jin Seok; Choi, Seong Ho; Choi, Dong Wook; Park, Sang Jae; Han, Sung‐Sik; Yoon, Dong Sup; Park, Joon Seong; Yu, Hee Chul; Kang, Koo Jeong; Kim, Sang Geol; Lee, Hongeun; Kwon, Wooil; Yoon, Yoo‐Seok; Han, Ho‐Seong; Kim, Sun‐Whe
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 24:Number 7(2017)
• Page Start: 426
• Page End: 433
• Publication Date: 2017-07
• Subjects: Extended resection -- Lymph node -- Nerve -- Pancreas cancer -- Survival analysis; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.465
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: Our previous randomized controlled trial revealed no difference in 2‐year overall survival (OS) between extended and standard resection for pancreatic adenocarcinoma. The present study evaluated the 5‐year OS and recurrence patterns according to the extent of pancreatectomy. Methods: Between 2006 and 2009, 169 consecutive patients were prospectively enrolled and randomized to standard ( n = 83) or extended resection ( n = 86) groups to compare 5‐year OS rate, long‐term recurrence patterns and factors associated with long‐term survival. Results: The surgical R0 rate was similar between the standard and extended groups (85.5 vs. 90.7%, P = 0.300). Five‐year OS (18.4 vs. 14.4%, P = 0.388), 5‐year disease‐free survival (14.8 vs. 14.0%, P = 0.531), and overall recurrence rates (74.7 vs. 69.9%, P = 0.497) were not significantly different between the two groups, although the incidence of peritoneal seeding was higher in the extended group (25 vs. 8.1%, P = 0.014). Conclusions: Extended pancreatectomy does not have better short‐term and long‐term survival outcomes, and shows similar R0 rates and overall recurrence rates compared with standard pancreatectomy. Extended pancreatectomy does not have to be performed routinely for all cases of resectable pancreatic adenocarcinoma, especially considering its associated increased morbidity shown in our previous study. Highlight: Jang and colleagues conducted a multicenter randomized controlled trial to evaluate long‐term overall survival and recurrence patterns according to the extent of pancreatectomy for pancreatic head cancer. Extended pancreatectomy did not demonstrate better short‐term and long‐term survival outcomes, and showed similar R0 rates and recurrence rates compared with standard pancreatectomy.