ABSTRACT
BACKGROUND: Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). METHODS: Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival. Secondary endpoints were radicality (R0-resection), 90-day mortality, major morbidity, and pancreatic fistulae (grade B/C). RESULTS: We included 68 patients from 20 hospitals in 12 countries. Postoperatively, 53% of patients had R0-resection, 25% major morbidity, 21% an ISGPS grade B/C pancreatic fistula, and 16% mortality. In total, 82% received (neo-)adjuvant chemotherapy and median overall survival in 62 patients with pancreatic ductal adenocarcinoma patients was 18 months (CI 10-37). We observed no impact of PHAE on ischemic complications. CONCLUSIONS: DP-CAR combined with chemotherapy for locally advanced pancreatic cancer is associated with acceptable overall survival. The 90-day mortality is too high and should be reduced. Future studies should investigate to what extent increasing surgical volume or better patient selection can improve outcomes.
Subject(s)
Carcinoma, Pancreatic Ductal/therapy , Embolization, Therapeutic , Pancreatectomy/adverse effects , Pancreatic Neoplasms/therapy , Postoperative Complications/etiology , Aged , Antineoplastic Agents/therapeutic use , Celiac Artery/surgery , Chemoradiotherapy, Adjuvant , Chemotherapy, Adjuvant , Europe/epidemiology , Female , Hepatic Artery , Hospitals, High-Volume/statistics & numerical data , Humans , Male , Middle Aged , Neoadjuvant Therapy , Pancreatectomy/methods , Pancreatectomy/mortality , Postoperative Complications/mortality , Postoperative Complications/surgery , Preoperative Period , Reoperation , Retrospective Studies , Survival RateABSTRACT
In the original article, the institutional author the E-AHPBA DP-CAR study group was misspelled. It is correct as reflected here. The original article has also been corrected.