Survival impact of distal pancreatectomy with en bloc celiac axis resection combined with neoadjuvant chemotherapy for borderline resectable or locally advanced pancreatic body carcinoma

The survival benefit associated with distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for patients with borderline resectable or locally advanced pancreatic body carcinoma is controversial. The aim of this study was to evaluate the impact of DP-CAR following neoadjuvant chemotherapy...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2021-04, Vol.21 (3), p.564-572
Main Authors: Murakami, Yoshiaki, Nakagawa, Naoya, Kondo, Naru, Hashimoto, Yasushi, Okada, Kenjiro, Seo, Shingo, Otsuka, Hiroyuki
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adrenal glands
Blood transfusion
Cancer therapies
Chemotherapy
Distal pancreatectomy
Distal pancreatectomy with en bloc celiac axis resection
Embolization
Fistula
Hepatic artery
Lymph nodes
Lymphatic system
Medical prognosis
Medical records
Metastasis
Morbidity
Multivariate analysis
Neoadjuvant chemotherapy
Pancreas
Pancreatectomy
Pancreatic body or tail carcinoma
Pancreatic cancer
Pancreatic carcinoma
Patients
Radiation therapy
Small intestine
Surgery
Survival
Tumors
Veins & arteries
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Summary:The survival benefit associated with distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for patients with borderline resectable or locally advanced pancreatic body carcinoma is controversial. The aim of this study was to evaluate the impact of DP-CAR following neoadjuvant chemotherapy on survival in patients with borderline resectable or locally advanced pancreatic body carcinoma. Medical records of patients with pancreatic ductal adenocarcinoma who underwent distal pancreatectomy (DP, n = 102) and DP-CAR following neoadjuvant chemotherapy (n = 32) between 2008 and 2019 were analyzed retrospectively. Short- and long-term outcomes were compared between the two groups. All patients who underwent DP-CAR had tumor contact with the celiac axis. Of these, 30 patients underwent preoperative embolization of the common hepatic artery. The pretreatment tumor size of patients who underwent DP-CAR was larger (P 
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2021.01.008