Kevin L Anderson1, Mohamed A Adam2, Samantha Thomas3, Sanziana A Roman4, Julie A Sosa5. 1. Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: kla24@duke.edu. 2. Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: mohamed.adam@dm.duke.edu. 3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA. Electronic address: samantha.thomas@dm.duke.edu. 4. Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA. Electronic address: sanziana.roman@dm.duke.edu. 5. Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA; Duke Cancer Institute, 20 Duke Medicine Circle, Durham, NC 27710, USA; Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA; Duke Clinical Research Institute, Durham, NC 27710, USA. Electronic address: julie.sosa@dm.duke.edu.
Abstract
BACKGROUND: Published data examining the impact of minimally invasive distal pancreatectomy (MIDP) on survival are generally limited to experiences from high-volume institutions. Our aim was to compare utilization of adjuvant chemoradiation and time from surgery until its initiation following MIDP vs. open surgery (ODP) at a national level. METHODS: Adult patients undergoing distal pancreatectomy for Stage I and II pancreatic adenocarcinoma were identified from the National Cancer Data Base, 2010-2012. RESULTS: A total of 1807 patients underwent distal pancreatectomy for adenocarcinoma at 506 institutions (27.9% MIDP). After adjustment, those who underwent MIDP were more likely to have complete tumor resections and a shorter hospital length of stay. Patients undergoing MIDP vs. ODP were more likely to receive adjuvant chemotherapy; time to initiation of adjuvant chemotherapy or radiation was not different between groups. After adjustment, overall survival for MIDP vs. ODP remained similar (HR 0.85, CI 0.67-1.10, p = 0.21). CONCLUSION: MIDP is associated with increased use of adjuvant chemotherapy; further study is needed to understand the etiology and impact of this association.
BACKGROUND: Published data examining the impact of minimally invasive distal pancreatectomy (MIDP) on survival are generally limited to experiences from high-volume institutions. Our aim was to compare utilization of adjuvant chemoradiation and time from surgery until its initiation following MIDP vs. open surgery (ODP) at a national level. METHODS: Adult patients undergoing distal pancreatectomy for Stage I and II pancreatic adenocarcinoma were identified from the National Cancer Data Base, 2010-2012. RESULTS: A total of 1807 patients underwent distal pancreatectomy for adenocarcinoma at 506 institutions (27.9% MIDP). After adjustment, those who underwent MIDP were more likely to have complete tumor resections and a shorter hospital length of stay. Patients undergoing MIDP vs. ODP were more likely to receive adjuvant chemotherapy; time to initiation of adjuvant chemotherapy or radiation was not different between groups. After adjustment, overall survival for MIDP vs. ODP remained similar (HR 0.85, CI 0.67-1.10, p = 0.21). CONCLUSION: MIDP is associated with increased use of adjuvant chemotherapy; further study is needed to understand the etiology and impact of this association.
Authors: Patricia C Conroy; Lucia Calthorpe; Joseph A Lin; Sarah Mohamedaly; Alex Kim; Kenzo Hirose; Eric Nakakura; Carlos Corvera; Julie Ann Sosa; Ankit Sarin; Kimberly S Kirkwood; Adnan Alseidi; Mohamed A Adam Journal: Ann Surg Oncol Date: 2021-11-01 Impact factor: 4.339
Authors: M Korrel; S Lof; J van Hilst; A Alseidi; U Boggi; O R Busch; S van Dieren; B Edwin; D Fuks; T Hackert; T Keck; I Khatkov; G Malleo; I Poves; M A Sahakyan; C Bassi; M Abu Hilal; M G Besselink Journal: Ann Surg Oncol Date: 2020-06-25 Impact factor: 5.344