Extended distal pancreatectomy for pancreatic adenocarcinoma with splenic vein thrombosis and/or adjacent organ invasion

Alexandra M. Roch, Harjot Singh, Alexandra P. Turner, Eugene P. Ceppa, Michael House, Nicholas Zyromski, Attila Nakeeb, C. Schmidt

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Patients with adenocarcinoma of the pancreatic body/tail and associated vascular thrombosis or adjacent organ invasion are suboptimal candidates for resection. We hypothesized that extended distal pancreatectomy (EDP) for locally advanced adenocarcinoma is associated with a survival benefit. Methods We retrospectively reviewed a prospectively collected database of patients who underwent distal pancreatectomy (DP) for adenocarcinoma at a single academic institution (1996 to 2011) with greater than or equal to 2 years of follow-up. Results Among 680 DP patients, 93 were indicated for pancreatic adenocarcinoma. Splenic vein thrombosis (n = 26) did not significantly affect morbidity, mortality, or survival. Standard DP was performed in 70 patients and 23 underwent EDP with no difference in morbidity/mortality. Patients with EDP had a survival comparable with patients with standard DP (disease-free survival 18 vs 12 months =.8; overall survival 23 vs 17 months, P =.6). There was no difference in survival between EDP patients with versus without pathologic invasion of adjacent organs, but a trend favored those without. Conclusion EDP is safe and should be considered in fit patients with locally advanced adenocarcinoma.

Original languageEnglish
Pages (from-to)564-569
Number of pages6
JournalAmerican Journal of Surgery
Volume209
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Splenic Vein
Pancreatectomy
Adenocarcinoma
Thrombosis
Survival
Morbidity
Mortality
Disease-Free Survival
Blood Vessels
Databases

Keywords

  • Adenocarcinoma of the pancreatic body/tail
  • Distal pancreatectomy
  • Extended resection
  • Outcomes

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Extended distal pancreatectomy for pancreatic adenocarcinoma with splenic vein thrombosis and/or adjacent organ invasion. / Roch, Alexandra M.; Singh, Harjot; Turner, Alexandra P.; Ceppa, Eugene P.; House, Michael; Zyromski, Nicholas; Nakeeb, Attila; Schmidt, C.

In: American Journal of Surgery, Vol. 209, No. 3, 01.03.2015, p. 564-569.

Research output: Contribution to journalArticle

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AU - Singh, Harjot

AU - Turner, Alexandra P.

AU - Ceppa, Eugene P.

AU - House, Michael

AU - Zyromski, Nicholas

AU - Nakeeb, Attila

AU - Schmidt, C.

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N2 - Background Patients with adenocarcinoma of the pancreatic body/tail and associated vascular thrombosis or adjacent organ invasion are suboptimal candidates for resection. We hypothesized that extended distal pancreatectomy (EDP) for locally advanced adenocarcinoma is associated with a survival benefit. Methods We retrospectively reviewed a prospectively collected database of patients who underwent distal pancreatectomy (DP) for adenocarcinoma at a single academic institution (1996 to 2011) with greater than or equal to 2 years of follow-up. Results Among 680 DP patients, 93 were indicated for pancreatic adenocarcinoma. Splenic vein thrombosis (n = 26) did not significantly affect morbidity, mortality, or survival. Standard DP was performed in 70 patients and 23 underwent EDP with no difference in morbidity/mortality. Patients with EDP had a survival comparable with patients with standard DP (disease-free survival 18 vs 12 months =.8; overall survival 23 vs 17 months, P =.6). There was no difference in survival between EDP patients with versus without pathologic invasion of adjacent organs, but a trend favored those without. Conclusion EDP is safe and should be considered in fit patients with locally advanced adenocarcinoma.

AB - Background Patients with adenocarcinoma of the pancreatic body/tail and associated vascular thrombosis or adjacent organ invasion are suboptimal candidates for resection. We hypothesized that extended distal pancreatectomy (EDP) for locally advanced adenocarcinoma is associated with a survival benefit. Methods We retrospectively reviewed a prospectively collected database of patients who underwent distal pancreatectomy (DP) for adenocarcinoma at a single academic institution (1996 to 2011) with greater than or equal to 2 years of follow-up. Results Among 680 DP patients, 93 were indicated for pancreatic adenocarcinoma. Splenic vein thrombosis (n = 26) did not significantly affect morbidity, mortality, or survival. Standard DP was performed in 70 patients and 23 underwent EDP with no difference in morbidity/mortality. Patients with EDP had a survival comparable with patients with standard DP (disease-free survival 18 vs 12 months =.8; overall survival 23 vs 17 months, P =.6). There was no difference in survival between EDP patients with versus without pathologic invasion of adjacent organs, but a trend favored those without. Conclusion EDP is safe and should be considered in fit patients with locally advanced adenocarcinoma.

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