Background: Distal pancreatectomy with celiac axis resection (DP-CAR) has been used for selected patients with pancreatic cancer infiltrating the celiac axis. We compared the short- and long-term outcomes between DP-CAR and distal pancreatectomy alone (DP) in patients receiving neoadjuvant therapy. Methods: Patients undergoing DP-CAR from 2013 to 2022 were retrospectively reviewed. Clinicopathologic features, post-operative morbidity, and survival outcomes were compared with patients undergoing DP after neoadjuvant chemotherapy. Results: Twenty-two DP-CAR and thirty-four DP patients who underwent neoadjuvant chemotherapy were identified. There were no differences in comorbidities or CA19-9 levels. OR time was longer for DP-CAR (304 vs. 240 min,p= 0.007), but there was no difference in the transfusion rate (22.7% vs. 14.7%). Vascular reconstruction was more common in DP-CAR (18.2% vs. 0% arterial,p= 0.05; 40.9% vs. 12.5% venous,p= 0.04). There was no difference in morbidity or mortality between the two groups. Although there was a trend towards larger tumors in DP-CAR (5.1 cm vs. 3.8 cm,p= 0.057), the overall survival from the initiation of treatment (32 vs. 28 months,p= 0.43) and surgery (30 vs. 24 months,p= 0.43) were similar. Discussion: DP-CAR is associated with similar survival and morbidity compared to DP patients requiring neoadjuvant chemotherapy and should be pursued in appropriately selected patients.
背景：腹腔干切除的远端胰腺切除术（DP-CAR）已应用于部分腹腔干受侵的胰腺癌患者。本研究比较了新辅助治疗患者中DP-CAR与单纯远端胰腺切除术（DP）的近期及远期疗效。方法：回顾性分析2013年至2022年接受DP-CAR的患者资料，将其临床病理特征、术后并发症及生存结局与新辅助化疗后接受DP的患者进行对比。结果：共纳入22例DP-CAR患者与34例DP患者，两组在合并症及CA19-9水平方面无显著差异。DP-CAR组手术时间更长（304分钟 vs. 240分钟，p=0.007），但输血率无统计学差异（22.7% vs. 14.7%）。DP-CAR组血管重建更为常见（动脉重建率18.2% vs. 0%，p=0.05；静脉重建率40.9% vs. 12.5%，p=0.04）。两组并发症发生率及死亡率无显著差异。尽管DP-CAR组肿瘤体积有增大趋势（5.1厘米 vs. 3.8厘米，p=0.057），但从治疗起始（32个月 vs. 28个月，p=0.43）及手术起始（30个月 vs. 24个月，p=0.43）计算的总生存期相似。结论：对于需要新辅助化疗的患者，DP-CAR与DP相比具有相似的生存率及并发症发生率，应在严格筛选的患者中积极实施该术式。
肿瘤(癌症)患者之家