Pancreaticoduodenectomy with Total Mesopancreas Excision for Pancreatic Head Cancer. Impact on Overall Survival

Abstract

Introduction: The pancreatic ductal head adenocarcinoma (PDHAC) is a lethal disease with poor prognosis. Surgical resection with complete microscopic resection (R0 status) in association with multimodal treatment currently represents the only strategy potentially resulting in long-term survival and cure. 5-year survival rate is only 20% to 25% and median survival is between 10 and 20 months. Total mesopancreas excision (TMpE) is a modified surgical technique that try to improve the rate of R1 resections at Superior Mesenteric Artery resection margin. The purpose of this study was to evaluate the impact of TMpE on the 1, 3 and 5-year overall survival (OS) rate and median survival (MS). Methods: This study included 93 patients with PDHAC who were treated in the Hepatobiliary Surgery Department of Miguel Servet University Hospital in Saragossa, Spain, during 7-year period (between October 1, 2010 and December 31, 2017). They were divided into two groups: Group A included patients who underwent PD treatment with TMpE resection of the arterial priority approach and Group B included patients who underwent standard PD (S-PD). The collected data were prospectively collected and statistically analyzed by SPSS 19.0 statistical software package. Results: See Table. There wasn’t significant difference between the two groups (p›0.05). Conclusions: TMpE improves overall survival rate and median survival on months but there wasn’t significant difference.Tabled 1EP02C-01812 months36 months60 monthsGroup AGroup BGroup AGroup BGroup AGroup BOS75%60%43.7%26.7%25%17.8%OM121224182817 Open table in a new tab