Evolution of pancreatectomy with en bloc venous resection for pancreatic cancer in Italy. Retrospective cohort study on 425 cases in 10 pancreatic referral units. (July 2018)

• Record Type: Journal Article
• Authors: Nigri, Giuseppe; Petrucciani, Niccolò; Pinna, Antonio Daniele; Ravaioli, Matteo; Jovine, Elio; Minni, Francesco; Grazi, Gian Luca; Chirletti, Piero; Balzano, Gianpaolo; Ferla, Fabio; De Carlis, Luciano; Tisone, Giuseppe; Napoli, Niccolò; Boggi, Ugo; Ramacciato, Giovanni
• Is Part Of: International journal of surgery. Volume 55(2018)
• Page Start: 103
• Page End: 109
• Publication Date: 2018-07
• Subjects: Pancreatic cancer -- Pancreatectomy -- Venous resection -- Time frame -- Italy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.05.025
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Introduction: The aim of this study is to analyze the evolution of pancreatectomy with venous resection in 10 referral Italian centers in the last 25 years. Methods: A multicenter database of 425 patients submitted to pancreatectomy with venous resection between 1991 and 2015 was retrospectively analyzed. Patients were classified in 5 periods: 1 (1991–1995); 2 (1996–2000); 3 (2001–2005); 4 (2006–2010); 5 (2011–2015). Indications and outcomes were compared according to the period of surgery. Results: Nineteen patients were operated in period 1, 28 in period 2, 91 in period 3, 140 in period 4, and 147 in period 5. Use of neoadjuvant therapy increased from 0% in period 1 and 2–12.1% in period 5. Postoperative complications ranged from 46.3% to 67.8%, and mortality from 5.3% to 9.2%. Median survival progressively increased, from 6 months in period 1–16 months in period 2, 24 months in period 3 and 4 and 35 months in period 5 (p = 0.004). Period, venous and nodal invasion were significant prognostic factors for survival. Conclusion: Management and outcomes of pancreatectomy with venous resection have evolved in the last 25 years in Italy. Improvement in patients' multidisciplinary management has lead to significant improvement of median survival. Highlights: The aim of this study is to evaluate the evolution of pancreatectomy with venous resection in Italy. Survival progressively improved during the study time frames. The period of surgery was a positive prognostic factor at multivariate analysis. Our results are encouraging and highlight the evolution of pancreatectomy with venous resection in Italy.