文章：

胰腺体尾部癌根治性顺行模块化胰脾切除术与传统远端胰脾切除术生存结果比较：韩国多中心倾向评分匹配分析

Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis

原文发布日期：18 April 2024

DOI: 10.3390/cancers16081546

类型: Article

开放获取: 是

英文摘要：

(1) Background: The aim of this study was to compare the survival benefit of radical antegrade modular pancreatosplenectomy (RAMPS) with conventional distal pancreatosplenectomy (cDPS) in left-sided pancreatic cancer. (2) Methods: A retrospective propensity score matching (PSM) analysis was conducted on 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer at four tertiary cancer centers. The study assessed prognostic factors and compared survival and operative outcomes. (3) Results: After PSM, 99 patients were matched in each group. RAMPS resulted in a higher retrieved lymph node count than cDPS (15.0 vs. 10.0,p< 0.001). No significant differences were observed between the two groups in terms of R0 resection rate, blood loss, hospital stay, or morbidity. The 5-year overall survival rate was similar in both groups (cDPS vs. RAMPS, 44.4% vs. 45.2%,p= 0.853), and disease-free survival was also comparable. Multivariate analysis revealed that ASA score, preoperative CA19-9, histologic differentiation, R1 resection, adjuvant treatment, and lymphovascular invasion were significant prognostic factors for overall survival. Preoperative CA19-9, histologic differentiation, T-stage, adjuvant treatment, and lymphovascular invasion were independent significant prognostic factors for disease-free survival. (4) Conclusions: Although RAMPS resulted in a higher retrieved lymph node count, survival outcomes were not different between the two groups. RAMPS was a surgical option to achieve R0 resection rather than a standard procedure.

摘要翻译： 

(1) 背景：本研究旨在比较根治性顺行模块化胰脾切除术（RAMPS）与传统远端胰脾切除术（cDPS）在左侧胰腺癌治疗中的生存获益差异。(2) 方法：对四家三级癌症中心接受RAMPS或cDPS治疗的333例左侧胰腺癌患者进行回顾性倾向评分匹配分析，评估预后因素并比较生存与手术结局。(3) 结果：经倾向评分匹配后，两组各纳入99例患者。RAMPS组淋巴结清扫数量显著高于cDPS组（15.0枚 vs. 10.0枚，p<0.001）。两组在R0切除率、术中失血量、住院时间及并发症发生率方面均无显著差异。5年总生存率相近（cDPS组 vs. RAMPS组：44.4% vs. 45.2%，p=0.853），无病生存率亦无统计学差异。多因素分析显示：ASA评分、术前CA19-9水平、组织学分化程度、R1切除、辅助治疗及淋巴血管侵犯是总生存的独立预后因素；术前CA19-9水平、组织学分化程度、T分期、辅助治疗及淋巴血管侵犯是无病生存的独立预后因素。(4) 结论：虽然RAMPS能获得更高的淋巴结清扫数量，但两组生存结局无显著差异。RAMPS是实现R0切除的可选术式，而非标准治疗方案。

原文链接：

Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis