Niccolò Petrucciani1, Tarek Debs2, Giuseppe Nigri3, Giulia Giannini3, Elena Sborlini3, Radwan Kassir4, Imed Ben Amor2, Antonio Iannelli2, Stefano Valabrega3, Francesco D'Angelo3, Jean Gugenheim2, Giovanni Ramacciato3. 1. Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, St Andrea Hospital, Rome, Italy; Division of Digestive Surgery and Liver Transplantation, Nice University Hospital, Nice, France. Electronic address: nicpetrucciani@hotmail.it. 2. Division of Digestive Surgery and Liver Transplantation, Nice University Hospital, Nice, France. 3. Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, St Andrea Hospital, Rome, Italy. 4. Department of General and Thoracic Surgery, St Etienne University Hospital, St Etienne, France.
Abstract
BACKGROUND: Multivisceral resections combined with pancreatectomy have been proposed in selected patients with tumor invasion into adjacent organs, in order to allow complete tumor resection. Some authors have also reported multivisceral resection combined with metastasectomy in very selected cases. The utility of this practice is debated. The aim of the review is to compare the postoperative results and survival of pancreatectomies combined with multivisceral resections with those of standard pancreatectomies. METHODS: A systematic literature search was performed to identify all studies published up to February 2017 that analyzed data of patients undergoing multivisceral and standard pancreatectomies. Clinical effectiveness was synthetized through a narrative review with full tabulation of results. RESULTS: Three studies were retrieved, including 713 (80%) patients undergoing standard pancreatectomies and 176 (20%) undergoing multivisceral resections (MVR). Postoperative morbidity ranged from 37% to 50% after standard resections and from 56% to 69% after MVR. In-hospital mortality ranged from 4% after standard pancreatectomies to 10% after MVR. Median survival ranged from 20 to 23 months in standard resections and from 12 to 20 months after MVR, without significant differences. DISCUSSION: The current literature suggests that multivisceral pancreatectomies are feasible and may increase the number of completely resected patients. Morbidity and mortality are higher than after standard pancreatectomies, and these procedures should be reserved to selected patients in referral centers. Further studies on the role of neoadjuvant therapy in this setting are advisable.
BACKGROUND: Multivisceral resections combined with pancreatectomy have been proposed in selected patients with tumor invasion into adjacent organs, in order to allow complete tumor resection. Some authors have also reported multivisceral resection combined with metastasectomy in very selected cases. The utility of this practice is debated. The aim of the review is to compare the postoperative results and survival of pancreatectomies combined with multivisceral resections with those of standard pancreatectomies. METHODS: A systematic literature search was performed to identify all studies published up to February 2017 that analyzed data of patients undergoing multivisceral and standard pancreatectomies. Clinical effectiveness was synthetized through a narrative review with full tabulation of results. RESULTS: Three studies were retrieved, including 713 (80%) patients undergoing standard pancreatectomies and 176 (20%) undergoing multivisceral resections (MVR). Postoperative morbidity ranged from 37% to 50% after standard resections and from 56% to 69% after MVR. In-hospital mortality ranged from 4% after standard pancreatectomies to 10% after MVR. Median survival ranged from 20 to 23 months in standard resections and from 12 to 20 months after MVR, without significant differences. DISCUSSION: The current literature suggests that multivisceral pancreatectomies are feasible and may increase the number of completely resected patients. Morbidity and mortality are higher than after standard pancreatectomies, and these procedures should be reserved to selected patients in referral centers. Further studies on the role of neoadjuvant therapy in this setting are advisable.
Authors: Oliver Beetz; Akin Sarisin; Alexander Kaltenborn; Jürgen Klempnauer; Michael Winkler; Gerrit Grannas Journal: World J Surg Oncol Date: 2020-08-20 Impact factor: 2.754
Authors: R Fietkau; R Grützmann; U A Wittel; R S Croner; L Jacobasch; U P Neumann; A Reinacher-Schick; D Imhoff; S Boeck; L Keilholz; H Oettle; W M Hohenberger; H Golcher; W O Bechstein; W Uhl; A Pirkl; W Adler; S Semrau; S Rutzner; M Ghadimi; D Lubgan Journal: Strahlenther Onkol Date: 2020-09-10 Impact factor: 3.621