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Minimally invasive versus open distal pancreatectomy for pancreatic neuroendocrine tumors: An analysis from the U.S. neuroendocrine tumor study group
Author(s) -
Zhang XuFeng,
LopezAguiar Alexandra G.,
Poultsides George,
Makris Eleftherios,
Rocha Flavio,
Kanji Zaheer,
Weber Sharon,
Fields Ryan,
Krasnick Bradley A.,
Idrees Kamran,
Smith Paula M.,
Cho Cliff,
Schmidt Carl R.,
Maithel Shishir K.,
Pawlik Timothy M.
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25481
Subject(s) - medicine , incidence (geometry) , neuroendocrine tumors , propensity score matching , pancreatectomy , cumulative incidence , cohort , gastroenterology , overall survival , surgery , pancreas , physics , optics
Background To determine short‐ and long‐term oncologic outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for the treatment of pancreatic neuroendocrine tumor (pNET). Methods The data of the patients who underwent curative MIDP or ODP for pNET between 2000 and 2016 were collected from a multi‐institutional database. Propensity score matching (PSM) was used to generate 1:1 matched patients with MIDP and ODP. Results A total of 576 patients undergoing curative DP for pNET were included. Two hundred and fourteen (37.2%) patients underwent MIDP, whereas 362 (62.8%) underwent ODP. MIDP was increasingly performed over time (2000‐2004: 9.3% vs 2013‐2016: 54.8%; P < 0.01). In the matched cohort (n = 141 in each group), patients who underwent MIDP had less blood loss (median, 100 vs 200 mL, P < 0.001), lower incidence of Clavien‐Dindo ≥ III complications (12.1% vs 24.8%, P = 0.026), and a shorter hospital stay versus ODP (median, 4 versus 7 days, P = 0.026). Patients who underwent MIDP had a lower incidence of recurrence (5‐year cumulative recurrence, 10.1% vs 31.1%, P < 0.001), yet equivalent overall survival (OS) rate (5‐year OS, 92.1% vs 90.9%, P = 0.550) compared with patients who underwent OPD. Conclusion Patients undergoing MIDP over ODP in the treatment of pNET had comparable oncologic surgical metrics, as well as similar long‐term OS.