Long term oncological outcomes of laparoscopic pancreatoduodenectomy

Abstract

Background: Two hundred and fifty laparoscopic pancreatoduodenectomies (LPDE) were performed in single center in patients with periampullary area diseases. Objective is to assess the long-term oncological outcomes of LPDE performed in patients with pancreatic head and ampullary carcinoma Methods: 250 patients underwent LPDE during 2007-2018 years. 216 patients had malignancies (125 had pancreatic cancer, 44 patients had ampullary carcinoma) and 34 had benign diseases. Patients were followed up by control examination and phone calls every year. Kaplan-Maier survival analysis was performed in order to analyze long term results of treatment. Results: 119 patients with PDAC and 44 patients with ampullary carcinoma were followed up. 114 patients with PDAC were referred to adjuvant. Only 63 patients received chemotherapy, 26 patients had no chemotherapy and data about 25 patients was not available. Median overall survival rate (OSR) of patients with PDAC was 21 months. 5-years OSR was 24%. Patient who did not receive adjuvant had significantly worse results with median OSR of 16 months vs 24 months. 5-years OSR of patients received chemo was significantly higher (27% vs 17%, p< 0.05). Another predictor of better survival was lymph nodes negativity, N+ patients had lower median OSR (26 months vs 18 months, p< 0.05) and 5-years OSR (27% vs 15%, p< 0.05). Patients with ampullary carcinoma had better oncological outcomes. Median OSR was 44 months and 5-years OSR was 52%. Conclusion: Lymph nodes positivity and non-receiving of adjuvant chemotherapy are predictors of lower survival rates in patients with pancreatic adenocarcinoma.