1556P Extended pancreatectomy in patients with pancreatic cancer

Abstract

Extended pancreatectomy (EP) is the only potential cure for patients with borderline resectable and locally advanced pancreatic cancer. In the period 2011-2018, 618 resections were performed in patients with pancreatic adenocarcinoma. Standard resections were performed in 476 (77%) patients. EP was performed in 142 (23%) patients. Extended pancreaticoduodenectomy was performed in 79 (55.6%), extended distal resections in 52 (36.6%), extended total pancreatectomy in 11 (7.8%). EP with arterial resections was performed in 14 (2.3%) patients, with venous resections in 91 (14.7%) patients. One or more postoperative complications occurred in 182 patients (38.2%) in the standard resection group and in 63 (44.3%) in the EP group. Mortality was 13.2% (15 patients): 6 (4.2%) patients died after EP and 9 (1.9%) after standard pancreatectomy. Median survival and 5-year overall survival rates were reduced in patients having EP compared with those undergoing a standard resection (15 months, 18% and 25 months, 33%, respectively; c2= 2.83, P= 0.09, c2 = 0.16, P=0.69). These results suggest that morbidity and mortality after EP are comparable with standard pancreatectomy. However, long term results of EP are worse compared with standard pancreatectomy. Extended resections are possible and can increase the number of radically operated patients.