Detailed Abstract
[BP Oral Presentation 2 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP OP 2-S7] Feasibility And Safety of Minimally Invasive Pancreaticoduodenectomy in Resectable/borderline Pancreatic Cancer Following Neoadjuvant Chemotherapy
Seung Soo HONG 1, Chang Moo KANG 1
1 Department of Surgery, Division of Hepatobiliary And Pancreas, Severance Hospital, REPUBLIC OF KOREA
Background : We conducted comparisonal analysis between minimally invasive pancreaticoduodenectomy(MIPD) and open pancreaticoduodenectomy(OPD) in resectable/borderline pancreatic cancer following neoadjuvant chemotherapy.
Methods : Total 183 patients were included diagnosed with resectable/borderline pancreatic cancer and who underwent PD following neoadjuvant chemotherapy in Severance hospital, Seoul, Korea (2006-2022). Of the 183 patients, 142 patients underwent OPD and 41 patient underwent MIPD (Laparoscopic 25, Robot assisted 16 cases). We compared preoperative characteristics, perioperative outcomes and oncologic outcomes between two groups.
Results : The demographic findings did not differ significantly, however MIPD showed more ratio of ASA class 3/4 (OPD 42.9% vs MIPD 70.7%, p=0.011). The tumor location, resectability and preoperative CA19-9 did not differ significantly. Most of the MIPD underwent FOLFIRINOX neoadjuvant chemotherapy(OPD: 36.6% vs MIPD 90.2%, p<0.001). MIPD showed superior results in blood loss (OPD: 663.9 vs MIPD: 331.7, p<0.001), intraoperative transfusion(OPD: 24.6% vs MIPD 7.3%, p=0.016) and hospital stay (OPD: 24.6 days vs MIPD: 16.3 days, p<0.001). Vascular resection ratio were similar (OPD: 38.7% vs MIPD: 34.1%, p=0.594). In oncologic outcomes, T, N staging, differentiation, LVI, PNI, resection margin(+) ratio and number of LN retrieval were comparable. 1 year disease free survival (DFS) and 1 year overall survival (OS) did not show significant differences between two groups (DFS: OPD 48.1% vs MIPD 67.3%, p=0.409; OS: OPD 80.2% vs MIPD 82.9%, p=0.691).
Conclusions : When compared with open surgery, minimally invasive pancreaticoduodenectomy can be feasible and safe to obtain negative resection margin in well selected patients following neoadjuvant therapy in resectable/borderline pancreatic cancer
Methods : Total 183 patients were included diagnosed with resectable/borderline pancreatic cancer and who underwent PD following neoadjuvant chemotherapy in Severance hospital, Seoul, Korea (2006-2022). Of the 183 patients, 142 patients underwent OPD and 41 patient underwent MIPD (Laparoscopic 25, Robot assisted 16 cases). We compared preoperative characteristics, perioperative outcomes and oncologic outcomes between two groups.
Results : The demographic findings did not differ significantly, however MIPD showed more ratio of ASA class 3/4 (OPD 42.9% vs MIPD 70.7%, p=0.011). The tumor location, resectability and preoperative CA19-9 did not differ significantly. Most of the MIPD underwent FOLFIRINOX neoadjuvant chemotherapy(OPD: 36.6% vs MIPD 90.2%, p<0.001). MIPD showed superior results in blood loss (OPD: 663.9 vs MIPD: 331.7, p<0.001), intraoperative transfusion(OPD: 24.6% vs MIPD 7.3%, p=0.016) and hospital stay (OPD: 24.6 days vs MIPD: 16.3 days, p<0.001). Vascular resection ratio were similar (OPD: 38.7% vs MIPD: 34.1%, p=0.594). In oncologic outcomes, T, N staging, differentiation, LVI, PNI, resection margin(+) ratio and number of LN retrieval were comparable. 1 year disease free survival (DFS) and 1 year overall survival (OS) did not show significant differences between two groups (DFS: OPD 48.1% vs MIPD 67.3%, p=0.409; OS: OPD 80.2% vs MIPD 82.9%, p=0.691).
Conclusions : When compared with open surgery, minimally invasive pancreaticoduodenectomy can be feasible and safe to obtain negative resection margin in well selected patients following neoadjuvant therapy in resectable/borderline pancreatic cancer
SESSION
BP Oral Presentation 2
Room C 3/22/2024 4:30 PM - 5:30 PM