Background Few evidences are available on the prognostic role of mesopancreas excision(MPe) for ampullary cancers(ACs). Aim of this study was to compare the long-term outcomes between pancreaticoduodenectomy(PD) with(PD-MPe group) and without(sPD group) MP. Methods Thirty-seven sPDs were matched and compared to 37 PD-MPes for perioperative outcomes, recurrence rate, disease-free(DFS) and overall survival(OS). Results The PD-MPe technique related to a significantly higher number of harvested lymph nodes[16 (±6)] as compared to the sPD [10 (±5); p < 0.0001]. Tumor recurrence was more frequent in the sPD cohort[21 (56.8%) vs 12 (32.4%) in the PD-MPe population; p = 0.03]. Although not statistically different, PD-MPe was associated with a better DFS(40% vs 35.7% for sPD; p = 0.08) and OS(59.3% vs 39.1% for sPD; p = 0.07). At the multivariate analysis, a higher number of lymph nodes retrieved and a more extensive lymphovascular clearance reached with the MPe technique, together with lymph nodes metastases, were recognized as independent prognostic factors for a worse OS and DFS. Discussion The PD-MPe technique is associated with a better oncological radicality thanks to the higher number of retrieved lymph nodes and to the more appropriate tumor clearance. This reflects in a lower incidence of tumor relapse and in improved outcomes in terms of OS and DFS.

Quero, G., Fiorillo, C., De Sio, D., Laterza, V., Menghi, R., Cina, C., Schena, C. A., Rosa, F., Galiandro, F., Alfieri, S., The role of mesopancreas excision for ampullary carcinomas: a single center propensity-score matched analysis, <<HPB>>, 2021; (24): 1-10. [doi:10.1016/j.hpb.2021.03.011] [http://hdl.handle.net/10807/177595]

The role of mesopancreas excision for ampullary carcinomas: a single center propensity-score matched analysis

Quero, Giuseppe;Fiorillo, Claudio;De Sio, Davide;Laterza, Vito;Menghi, Roberta;Schena, Carlo A.;Rosa, Fausto;Alfieri, Sergio
2021

Abstract

Background Few evidences are available on the prognostic role of mesopancreas excision(MPe) for ampullary cancers(ACs). Aim of this study was to compare the long-term outcomes between pancreaticoduodenectomy(PD) with(PD-MPe group) and without(sPD group) MP. Methods Thirty-seven sPDs were matched and compared to 37 PD-MPes for perioperative outcomes, recurrence rate, disease-free(DFS) and overall survival(OS). Results The PD-MPe technique related to a significantly higher number of harvested lymph nodes[16 (±6)] as compared to the sPD [10 (±5); p < 0.0001]. Tumor recurrence was more frequent in the sPD cohort[21 (56.8%) vs 12 (32.4%) in the PD-MPe population; p = 0.03]. Although not statistically different, PD-MPe was associated with a better DFS(40% vs 35.7% for sPD; p = 0.08) and OS(59.3% vs 39.1% for sPD; p = 0.07). At the multivariate analysis, a higher number of lymph nodes retrieved and a more extensive lymphovascular clearance reached with the MPe technique, together with lymph nodes metastases, were recognized as independent prognostic factors for a worse OS and DFS. Discussion The PD-MPe technique is associated with a better oncological radicality thanks to the higher number of retrieved lymph nodes and to the more appropriate tumor clearance. This reflects in a lower incidence of tumor relapse and in improved outcomes in terms of OS and DFS.
Inglese
HPB
Quero, G., Fiorillo, C., De Sio, D., Laterza, V., Menghi, R., Cina, C., Schena, C. A., Rosa, F., Galiandro, F., Alfieri, S., The role of mesopancreas excision for ampullary carcinomas: a single center propensity-score matched analysis, <>, 2021; (24): 1-10. [doi:10.1016/j.hpb.2021.03.011] [http://hdl.handle.net/10807/177595]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/177595
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