Long-term effects of total vs. partial pancreatectomy among patients with pancreatic cancer: a population-based study.

Autor:	Yang Z; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Tao Q; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Mijiti S; The Second Department of General Surgery, The First People's Hospital of Kashi Prefecture, Kashi, China., Luo D; Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China., Tang X; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Liu J; Department of Neurology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China., Jiang L; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Liu Z; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Liang C; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Tu X; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Zhao P; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Luu AM; St. Georg Klinikum Eisenach, Teaching Hospital of the University of Jena, Jena, Germany., Serra F; Department of Surgery, University of Modena and Reggio Emilia-Policlinico of Modena, Modena, Italy., Gelmini R; Department of Surgery, University of Modena and Reggio Emilia-Policlinico of Modena, Modena, Italy., Wang Y; The First Department of General Surgery, The First People's Hospital of Kashi Prefecture, Kashi, China., Zheng Y; Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.; State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Jazyk:	angličtina
Zdroj:	Annals of translational medicine [Ann Transl Med] 2022 May; Vol. 10 (10), pp. 539.
DOI:	10.21037/atm-22-2217
Abstrakt:	Background: Total pancreatectomy (TP) for pancreatic cancer (PC) has been limited historically for fear of elevated perioperative morbidity and mortality. With advances in perioperative care, TP may be an alternative option to partial pancreatectomy (PP). Limited evidence clarified the indication for these two procedures in PC patients, especially in patients with different tumor staging and location. Thus, this study aims to compare the outcomes after TP and PP for PCs of different T stages and locations. Methods: The study identified 14,456 PC patients with potentially curable primary tumor (T1-3) who received TP or PP from the Surveillance, Epidemiology, and End Results (SEER) database during 2000 to 2016. Detailed clinical and tumor covariates were all collected. Overall survival (OS) and cancer-specific survival (CSS) were the primary endpoints of interest in this study. OS and CSS were compared between patients after TP and PP using log-rank analysis. Results: For all patients, except for tumor location, TP group was comparable to the PP group. OS and CSS of the TP group were worse than of the PP group (median OS: 19 vs. 20 months, P=0.0058; median CSS: 24 vs. 26 months, P=0.00098, respectively). In stratifying analyses, TP was significantly related to worse OS and CSS than PP in pancreatic head and neck cancer patients with T2-stage tumors (median OS: 18 vs. 19 months, P=0.0016; median CSS: 22 vs. 24 months, P=0.00055, respectively), whereas for patients with T1- or T3-stage pancreatic head and neck cancer as well as T1- to T3-stage pancreatic body and tail cancer or overlapping location cancer, OS and CSS of the two groups were similar (all P>0.05). Conclusions: Compared with PP, TP offered worse prognosis in pancreatic head and neck cancer patients with T2-stage tumors, furthermore, TP and PP achieved comparable prognosis in patients with T1- or T3-stage pancreatic head and neck cancer as well as T1- to T3-stage pancreatic body and tail cancer or overlapping location cancer. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-2217/coif).The authors have no conflicts of interest to declare. (2022 Annals of Translational Medicine. All rights reserved.)
Databáze:	MEDLINE
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