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Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study
Author(s) -
Jang JinYoung,
Kang Jae Seung,
Han Youngmin,
Heo Jin Seok,
Choi Seong Ho,
Choi Dong Wook,
Park Sang Jae,
Han SungSik,
Yoon Dong Sup,
Park Joon Seong,
Yu Hee Chul,
Kang Koo Jeong,
Kim Sang Geol,
Lee Hongeun,
Kwon Wooil,
Yoon YooSeok,
Han HoSeong,
Kim SunWhe
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.465
Subject(s) - medicine , pancreatectomy , randomized controlled trial , pancreatic cancer , incidence (geometry) , adenocarcinoma , survival rate , surgery , gastroenterology , resection , cancer , physics , optics
Background Our previous randomized controlled trial revealed no difference in 2‐year overall survival ( OS ) between extended and standard resection for pancreatic adenocarcinoma. The present study evaluated the 5‐year OS and recurrence patterns according to the extent of pancreatectomy. Methods Between 2006 and 2009, 169 consecutive patients were prospectively enrolled and randomized to standard ( n = 83) or extended resection ( n = 86) groups to compare 5‐year OS rate, long‐term recurrence patterns and factors associated with long‐term survival. Results The surgical R0 rate was similar between the standard and extended groups (85.5 vs. 90.7%, P = 0.300). Five‐year OS (18.4 vs. 14.4%, P = 0.388), 5‐year disease‐free survival (14.8 vs. 14.0%, P = 0.531), and overall recurrence rates (74.7 vs. 69.9%, P = 0.497) were not significantly different between the two groups, although the incidence of peritoneal seeding was higher in the extended group (25 vs. 8.1%, P = 0.014). Conclusions Extended pancreatectomy does not have better short‐term and long‐term survival outcomes, and shows similar R0 rates and overall recurrence rates compared with standard pancreatectomy. Extended pancreatectomy does not have to be performed routinely for all cases of resectable pancreatic adenocarcinoma, especially considering its associated increased morbidity shown in our previous study.