Surgical Approach does not Affect Return to Intended Oncologic Therapy Following Pancreaticoduodenectomy for Pancreatic Adenocarcinoma: A Propensity-Matched Study.

Autor: Naffouje SA; Department of Surgical Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Kamarajah SK; Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne NHS Trust, Newcastle, UK.; Newcastle University, Newcastle, UK., Denbo JW; GI Oncology Program, H. Lee Moffitt Cancer Center, Tampa, FL, USA., Salti GI; Department of General Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.; Department of Surgical Oncology, Edward-Elmhurst Health, Naperville, IL, USA., Dahdaleh FS; Department of Surgical Oncology, Edward-Elmhurst Health, Naperville, IL, USA. Fadi.Dahdaleh@EEHealth.org.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2022 Nov; Vol. 29 (12), pp. 7793-7803. Date of Electronic Publication: 2022 Aug 12.
DOI: 10.1245/s10434-022-12347-w
Abstrakt: Background: The effect of minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic and robotic pancreaticoduodenectomy (LPD and RPD, respectively), on compliance and time to return to intended oncologic therapy (RIOT) for pancreatic ductal adenocarcinoma (PDAC) remains unknown.
Patients and Methods: Patients with nonmetastatic PDAC were analyzed in the National Cancer Database (NCDB). Three groups were matched per propensity score: open pancreaticoduodenectomy (OPD) and MIPD, LPD and RPD, and converted and nonconverted patients. RIOT rates and time to RIOT were examined.
Results: A total of 14,135 patients were included: 11,834 (83.7%) underwent OPD and 2301 (16.3%) underwent MIPD. After score matching, RIOT rates (67.2 vs. 65.3%; p = 0.112) and RIOT within 8 weeks (57.7 vs. 56.4%; p = 0.276) were similar among MIPD and OPD groups, and approach was not a significant predictor of RIOT on multivariable regression. Neither RIOT nor time to RIOT were different among LPD and RPD groups (63.9 vs. 67.0%, and 58.4 vs. 56.9%, respectively). Compared with LPD, RPD was associated with lower conversion rates (HR 0.519; p < 0.001), and conversion was associated with longer median time to RIOT (10 vs. 8 weeks; p = 0.041).
Conclusion: In this national cohort, approach did not impact RIOT rates or time to RIOT for patients with PDAC. While conversion was associated with longer median time to RIOT, readiness to commence adjuvant therapy was similar for LPD and RPD.
(© 2022. Society of Surgical Oncology.)
Databáze: MEDLINE
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